ABSTRACT Background: Nephrotic syndrome is a clinical condition characterized by massive urinary loss of protein, primarily albumin, which leads to hypoproteinemia (hypoalbuminemia) and edema. In childhood nephrotic syndrome, the most common complications are those secondary to hypovelemia and edema. Clinically apparent edema is usually not seen until serum albumin levels drop below 2 g/dl. Standard treatment has been loop diuretics with aldosterone antagonist such as spironolactone. If these fail, then intravenous 20% albumin with furosemide is usually used. The usefulness of albumin in the treatment of nephrotic syndrome in combination with furosemide is controversial and has not been proven. Objective: To compare the efficacy of albuminpost infusion furosemide and albumin-furosemide incorporation in decreasing nephrotic edema in children. Study Design: Randomized Controlled Trial Methodology: This is a single blinded prospective study with randomly selected children using simple random sampling. The population considered for inclusion in this study were newly diagnosed idiopathic nephrotic syndrome children ages 1-16 years with anasarca and in relapse. Patients with secondary nephrotic syndrome, such as with clinical features of systemic lupus erythematosus, Henoch Schonlein purpura, and/or evidence of systemic disease were excluded. The study was performed during relapse and the patients were admitted. Informed consents were obtained from the parent or guardian prior to the therapy. The 17 subjects were randomized to “Group A” which received albumin-post infusion furosemide while the other 17 subjects were randomized to “Group B” which received albumin-furosemide incorporation. The following parameters were recorded: heart rate (beats/ min), body weight (kg.), abdominal circumference (CM), pretibial edema (-/4+), urine output (ml/k/hr), hematocrit (%), serum albumin (mg/dl) and blood pressure (mm Hg) observed at 0, 6 and 24 hours from infusion.Urine output in cc/kg was measured at 8, 16 and 24 hours after infusion. The therapy protocol used in this study was 1g/ kg albumin to run for 1 hour intravenously followed by furosemide to be given at 2 mg/k/dose as slow intravenous push immediately after infusion for Group A. Group B received same doses of albumin and furosemide; however, furosemide was incorporated to the albumin solution and this was infused for 1 hour. Statistical analyses were performed in Statistical Package for the Social Sciences software (SPSS version 10). Chi-square and independent t-tests were used to describe sex, age, and height distribution between the two groups. Repeated measures ANOVA were employed to test for the difference in the means between treatment groups and across time. Difference in means at each time measurement and changes in the parameters from the baseline to 6 hours and 24 hours post-infusion were evaluated using independent t-tests. Differences in pretibial edema between treatment groups and across time were evaluated using Friedman test. The Mann-Witney U test were used to test the difference of the pretibial edema between the groups in each time measurement. A p-value of <0.05 was considered statistically significant. Results: Thirty-four (34) children were included in the study. The mean age for “Group A” (albumin postinfusion furosemide group) was 8.9 years (SD + 4.3) while the mean age for “Group B” (albumin-furosemide incorporation group) was 8 years (SD + 4.7). There were male children in Group A (58.8%) compared to Group B (41.2%) Test for differences in distribution of males and females, mean age and mean height between the two groups were not significant (p value >0.05).The decrease in heart rates, abdominal circumference, pretibial edema, hematocrit and change in serum albumin level from baseline to 24 hours infusion were significant with the pvalues of 0.001, 0.000, 0.000, 0.000, 0.000 respectively in both groups. The mean urine output between the two in body weight from baseline to 2 hours after infusion was significant in both groups. Only 1 male patient belonging to Group A developed itchiness. Conclusion: The efficacy of albumin-post infusion furosemide is comparable to albumin-furosemide incorporation in decreasing nephrotic edema, specifically in decreasing the body weight and abdominal circumference. There was significant increase in urine output in both groups. No serious side effects were noted except for 1 case of pruritus. Keywords: Nephrotic Syndrome, nephrotic edema albumin, furosemide, relapse