Mechanisms of Extracellular Fluid Volume Expansion in Nephrotic Syndrome


Changes in plasma protein concentration affect the net oncotic pressure difference across capillaries (wc - wi) in humans. Note that moderate reductions in plasma protein concentration have little effect on differences in transcapillary oncotic pressure. Only when plasma protein concentration decreases below 5 g/dL do changes become significant. (Data from Fadnes and coworkers [69].)



Time course of recovery from minimal change nephrotic syndrome in five children. Note that urinary Na excretion (squares) increases before serum albumin concentration increases. The data suggest that the natriuresis reflects a change in intrinsic renal Na retention. The data also emphasize that factors other than hypoalbuminemia must contribute to the Na retention that occurs in nephrosis. UNaV—urinary Na excretion volume. (Data from Oliver and Owings [70].)

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