Biomaterial Database

Lowered tissue-fluid oncotic pressure protects the blood volume in the nephrotic syndrome. 1986

H A Koomans, and A B Geers, and E J Dorhout Mees, and W Kortlandt

We have studied the role of adjustments of tissue-fluid colloid osmotic pressure (COP) in the maintenance of the blood volume in 10 patients with the nephrotic syndrome before and after diuretic treatment until dry weight. A mean weight reduction of 13.5 +/- 6.4 kg was attended by a fall in blood volume in 3 patients and no change in 6, but the final blood volume was within the normal range: 84.3 +/- 3.7 ml/kg (normal value: 87.6 +/- 8.8 ml/kg). Albumin content and COP of tissue-fluid, obtained with subcutaneous wicks, were low before edema removal and rose slightly after it, parallel to changes in the plasma. Thus, the transcapillary gradient in COP did not change: 6.5 +/- 1.5 mm Hg before and 6.2 +/- 1.7 mm Hg after diuretic treatment. Considering the low COP, 8.6 +/- 1.6 mm Hg in edematous and 11.7 +/- 3.7 mm Hg in dry conditions, this gradient was only slightly below the value of about 10 mm Hg normally found with this technique. We conclude that a lowered tissue-fluid COP is important for the preservation of blood volume in dry patients with the nephrotic syndrome. In addition, this adaptation can explain why the blood volume is often normal and not expanded despite the sometimes huge overhydration in these patients.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009404	Nephrotic Syndrome	A condition characterized by severe PROTEINURIA, greater than 3.5 g/day in an average adult. The substantial loss of protein in the urine results in complications such as HYPOPROTEINEMIA; generalized EDEMA; HYPERTENSION; and HYPERLIPIDEMIAS. Diseases associated with nephrotic syndrome generally cause chronic kidney dysfunction.	Childhood Idiopathic Nephrotic Syndrome,Frequently Relapsing Nephrotic Syndrome,Multi-Drug Resistant Nephrotic Syndrome,Pediatric Idiopathic Nephrotic Syndrome,Steroid-Dependent Nephrotic Syndrome,Steroid-Resistant Nephrotic Syndrome,Steroid-Sensitive Nephrotic Syndrome,Multi Drug Resistant Nephrotic Syndrome,Nephrotic Syndrome, Steroid-Dependent,Nephrotic Syndrome, Steroid-Resistant,Nephrotic Syndrome, Steroid-Sensitive,Nephrotic Syndromes,Steroid Dependent Nephrotic Syndrome,Steroid Resistant Nephrotic Syndrome,Steroid Sensitive Nephrotic Syndrome,Steroid-Dependent Nephrotic Syndromes,Steroid-Resistant Nephrotic Syndromes,Steroid-Sensitive Nephrotic Syndromes,Syndrome, Nephrotic,Syndrome, Steroid-Sensitive Nephrotic
D009994	Osmolar Concentration	The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per liter of solution. Osmolality is expressed in terms of osmoles of solute per kilogram of solvent.	Ionic Strength,Osmolality,Osmolarity,Concentration, Osmolar,Concentrations, Osmolar,Ionic Strengths,Osmolalities,Osmolar Concentrations,Osmolarities,Strength, Ionic,Strengths, Ionic
D001810	Blood Volume	Volume of circulating BLOOD. It is the sum of the PLASMA VOLUME and ERYTHROCYTE VOLUME.	Blood Volumes,Volume, Blood,Volumes, Blood
D004232	Diuretics	Agents that promote the excretion of urine through their effects on kidney function.	Diuretic,Diuretic Effect,Diuretic Effects,Effect, Diuretic,Effects, Diuretic
D004487	Edema	Abnormal fluid accumulation in TISSUES or body cavities. Most cases of edema are present under the SKIN in SUBCUTANEOUS TISSUE.	Dropsy,Hydrops,Anasarca
D005110	Extracellular Space	Interstitial space between cells, occupied by INTERSTITIAL FLUID as well as amorphous and fibrous substances. For organisms with a CELL WALL, the extracellular space includes everything outside of the CELL MEMBRANE including the PERIPLASM and the cell wall.	Intercellular Space,Extracellular Spaces,Intercellular Spaces,Space, Extracellular,Space, Intercellular,Spaces, Extracellular,Spaces, Intercellular
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man