Extracellular fluid volume in the hypoalbuminemic diabetic patient

Research output: Chapter in Book/Report/Conference proceedingChapter


Edema formation in the majority of patients with the nephrotic syndrome can best be explained by an overfill mechanism. This is particularly true for those patients with diabetic nephropathy. The maintenance of a normal plasma volume in the setting of hypoalbuminemia is the result of a series of edema preventing factors that act both to oppose fluid filtration across the capillary wall and to return fluid back into the vascular tree. The single most important variable in determining whether these factors are sufficient to prevent edema formation is the degree of renal salt retention. The variability in renal salt retention explains the poor correlation between the presence or absence of edema and the serum albumin concentration. The precise derangement in renal salt excretion has not been precisely localized but appears to reside in the distal nephron. The exact mechanism underlying this defect is unknown.

Original languageEnglish (US)
Title of host publicationThe Kidney in Heart Failure
PublisherSpringer US
Number of pages15
ISBN (Electronic)9781461436942
ISBN (Print)1461436931, 9781461436935
StatePublished - Nov 1 2012

ASJC Scopus subject areas

  • Medicine(all)


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