Causes of Edema
By mchern • Nov 25th, 2007 • Category: Water Generation & Elimination(Tissue) Edema is caused by:
1. that which happens in the capillaries: controls capillary fluid exchange
- the four possible reasons are found here: http://www.cvphysiology.com/Microcirculation/M010.htm
- note the interesting fact that heart failure can cause capillary hydrostatic pressure to increase
- here’s the link on the formula on fluid flux (see also EFP aka effective filtratin pressure): http://www.cvphysiology.com/Microcirculation/M011.htm
- and further definition of hydrostatic and oncotic pressures: http://www.cvphysiology.com/Microcirculation/M012.htm
in any case, edema happens when the increase in net filtration (i.e. filtration - reabsorption) much more than lymph flow can handle.
2. that which happens in the kidneys: i.e. sodium-water retention when the glomerulus-tubule balance gets out of balance
- it’s either
- GFR dropping, or
- e.g. glomerulus nephritis in nephritic syndrome or nephrosis when less water passes through
- e.g. hyperemic heart failure, 肾病综合症,cirrhosis cum ascites when effective blood flowing through is reduced, causing further constriction of renal blood vessels
- tubules increasing reabsorption
- aldo increases
- adh increases
- anp falls
- ff increase (more than 20%) due to efferent vessel constricting moe than usual
- redistribution of blood in kidneys, increasing renin and angiotensin production and secretion
- GFR dropping, or
note1: most problems come about when the glomerulus-tubule balance gets out of balance (i.e. of the water passing the glomerulus, a higher fraction - e.g. sodium absorption will be more than the normal 65-70% - is reabsorbed). normally, 99% of the water that passes the glomerulus is reabsorbed in the tubules. in the case of sodium-water retention, it could be more.
note2: that also tells us that glomerulus problems may not show edematous signs in the early stages of a kidney problem, cos as a parameter, its weightage in water retention is so much less that that of reabsorption.