RAISED VENOUS PRESSURE: A DIRECT CAUSE OF RENAL SODIUM RETENTION IN OEDEMA?

doi:10.1016/S0140-6736(88)91851-X

The Lancet

Volume 331, Issue 8593, 7 May 1988, Pages 1033-1036

https://doi.org/10.1016/S0140-6736(88)91851-X Get rights and content

Abstract

Contemporary theories of oedema formation are often based on the idea that "effective" blood volume is reduced, and that sodium retention and oedema are a result of the kidney responding, as in haemorrhage, to a perception by receptors in the circulation that blood volume is inadequate. This idea has enhanced understanding of the pathophysiology of such conditions as cardiac failure and cirrhosis, but has obscured the fact that blood volume is almost always increased in oedematous states. Evidence is presented that an increase in renal venous pressure can cause sodium retention by a direct action on the kidney: a rise in venous pressure could thereby initiate a vicious circle by causing sodium retention, expansion of plasma volume, and further increase in venous pressure. This sequence of events may be crucial in the pathophysiology of cor pulmonale, and an exacerbating factor in other oedematous states.

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Occasional SurveysRAISED VENOUS PRESSURE: A DIRECT CAUSE OF RENAL SODIUM RETENTION IN OEDEMA?

Abstract

Am J Med

Kidney Int

Am J Med

Lancet

Am Heart J

Am Heart J

Edema and decreased renal blood flow in patients with chronic congestive heart failure: evidence of "forward failure" as the primary cause of edema

J Clin Invest

Renal circulation in cirrhosis: observations based on catheterization of the renal vein

J Clin Invest

Renal response to non shocking hemorrhage: role of the autonomic nervous system and of the renal circulation

Am J Physiol

Renal response to non-shocking haemorrhage. Sodium retention at constant perfusion pressure

Proc Soc Exp Biol Med

Changes in blood viscosity, hematocrit value and fibrinogen concentration in subjects with congestive heart failure

Circulation

Fluid dynamics in chronic congestive heart failure: an interpretation of the mechanisms producing edema, increased plasma volume and elevated venous pressure in certain patients with prolonged congestive failure

Arch Intern Med

Effects of an arteriovenous fistula on renal hemodynamics and electrolyte excretion

J Clin Invest

Effects of cardiovascular reflexes on net capillary fluid transfer

Acta Physiol Scand

Autoregulation of flow in isolated rat kidney in the absence of red cells

Am J Physiol

Sodium reabsorption in the perfused rat kidney

Am J Physiol

Improved function with amino acids in the isolated perfused kidney

Am J Physiol

Effect of increased renal venous pressure on renal function

Am J Physiol

Effects of partial graded venous obstruction on electrolyte clearance by the dog's kidney

Am J Physiol

Occasional Surveys
RAISED VENOUS PRESSURE: A DIRECT CAUSE OF RENAL SODIUM RETENTION IN OEDEMA?