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Why do patients with renal swelling?

May 07, 2017

The cause of high edema in nephrotic syndrome:
(1)   the decrease of plasma colloid osmotic pressure: the exchange of blood and body fluid inside and outside the body is regulated by the osmotic pressure on both sides. Osmotic pressure including crystal osmotic pressure and colloid osmotic pressure, the former from crystal material (mainly because of its free electrolyte), through the capillary wall, so it has little effect on vascular and fluid exchange; the latter mainly from protein (mainly albumin), because it cannot free through the capillary wall, which is a major factor in the blood vessels exchange of body fluids. Nephrotic syndrome, due to a large number of protein loss in the urine and plasma, caused by hypoproteinemia, resulting in plasma colloid osmotic pressure decreased, when the normal 3.3 ~ 4kPa to 0.8 ~ 1.1kPa, to the high permeability of the interstitial fluid movement of intravascular water, and edema.
(2)   effective blood volume reduction: plasma water moves the effective blood volume reduction, which led to the following changes in vivo: by volumereceptor the antidiuretic hormone (ADH) increased, the renal tubular reabsorption of water increased; by the activation of renin angiotensin aldosterone system, aldosterone producing secondary histiocytosis, make renal tubular sodium reabsorption; inhibition of natriuretic factor production to reduce renal sodium excretion. So the body of water, sodium retention, further aggravated edema.
These two factors together lead to a high degree of edema in nephrotic syndrome.

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