ABSTRACT
This chapter describes few common renal syndromes which can result in edema. The primary emphasis is directed toward those renal mechanisms which develop in the organism's attempt to maintain salt and water homeostasis in chronic renal failure. The chapter reviews both the hypoalbuminemia and the compensatory mechanisms involved in attempts of the system to maintain an effective intravascular volume. It also reviews edema in the acute nephritic syndrome, e.g., acute glomerulonephritis. The role of physical factors as effectors of proximal tubular absorption in severe renal failure is uncertain. The afferent pathways modulating sodium excretion in chronic renal failure have not been studied. A second study, using clearance techniques and infusion of iso-oncotic saline, dopamine, and vasodilators, suggests that peritubular hydrostatic and oncotic pressure can continue to regulate proximal tubular reabsorption in chronic renal failure. Two reports in humans suggest that the edematous nephrotic patient lacks plasma natriuretic activity.
