Hypovolemic Shock and Hypotension as a Complication in the Nephrotic Syndrome Report of Ten Cases

CLINICAL DESCRIPTIONS of circulatory in-sufficiency in the nephrotic syndrome are few despite the established observation that a reduction in blood volume is found in this disease state (1-15). According to Squire (13), total blood volume in patients with the nephrotic syndrome may be de-creased to 70 to 80 per cent of normal. Acute decreases in blood volume of this magnitude in other clinical situations have often been associated with shock or hypo-tension (16-21). Between 1944 and 1960, we have seen the occurrence of shock or hypotension in 10 adult patients with the nephrotic syndrome. The patients were studied during periods of hospitalization at the University of Cali-fornia Medical Center; in most of these cases serial blood volume measurements were carried out. This report reviews the clinical and laboratory findings during the course of illness in these patients in relation to the possible factors responsible for the episodes of shock or hypotension