OBJECTIVE: To study the evidence-based therapy of edema in nephrotic syndrome by 
analyzing the literatures systematically.
METHODS: The literatures related to the treatment of nephrotic edema were 
retrieved from the following: Chinese Biological Medicine Database (CBM-disk), 
Chinese Journals Full-text Database (CNKI, 1994-2006), Chinese Technological 
Periodicals Database (VIP, 1989-2006), Chinese Evidence Biological 
Medicine/Cochrane Central Database (CEBM/CCD), Cochrane Library Database, 
MEDLINE (1966-2006), EMBASE (1975-2006), MEDLARS, SCI (1985-2006) and OVID by 
electron and craft search with the following key words: nephrotic syndrome, 
edema, recalcitrant edema, refractory edema or resistant nephrotic edema, and 
treatment, diuretic therapy or human albumin treatment. The relevant literatures 
on randomized controlled trials (RCT) that met the criteria were statistically 
analyzed by the Coorporative network software RevMan 4.2.
RESULTS: A total of 113 articles were searched (60 in Chinese and 53 in 
English), of which 12 were RCT. Three of the 12 articles were included for Meta 
analysis. Meta analysis showed that dextran-40 together with furosemide was 
effective for nephrotic edema. Human albumin solution could be used in nephrotic 
edema patients with coexistent severe hypoalbuminemia. A combination of 
diuretics by intravenous drip infusion was effective for diuretic-resistant 
nephrotic edema.
CONCLUSIONS: The treatment for nephrotic edema should be individualized. The 
evidence of treatment of nephrotic edema has not been fully elucidated. Further 
multicentre, large sample, and randomized controlled trials are needed.