Lowered Protein Content of Tissue Fluid in Patients with the Nephrotic Syndrome: Observations during Disease and Recovery

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Abstract
The transcapillary (plasma-tissue fluid) COP [colloid osmotic pressure] difference was measured in 12 patients with the nephrotic syndrome, as well as in 6 patients during complete (n = 3) and partial (n = 3) recovery to determine why most patients with the nephrotic syndrome maintain a normal blood volume despite a reduced COP. S.c. nylon wicks were used to collect tissue fluid. The albumin content was also measured. The albumin content and COP were lowered in both plasma and tissue fluid in the nephrotic phase, and rose gradually during recovery. During these changes the transcapillary COP difference only rose slightly: from 6.2 .+-. 1.7 mm Hg when the plasma COP was below 10 min Hg (n = 11) to 8.7 .+-. 1.5 mm Hg when the plasma COP exceeded 20 mm Hg (n = 12). In hypoproteinemia preservation of the intravascular volume is strongly dependent on maintenance of the difference in oncotic pressure across the capillary wall.

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