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- Title
The importance of plasma protein for blood volume and blood pressure homeostasis.
- Authors
Koomans, Hendrik A.; Braam, Branko; Geers, Anton B.; Roos, Jan C.; Dorhout Mees, Evert J.
- Abstract
To evaluate the influence of plasma protein concentration and colloid osmotic pressure (COP) on blood volume and blood pressure, we studied 40 patients with the nephrotic syndrome (plasma protein 41.1 ± 5.3 g/liter, COP 10.9 ± 2.2 mm Hg) and 43 patients with chronic renal failure (plasma protein 65.0 ± 5.8 g/liter, COP 22.4 ± 3.0 mm Hg) at overhydration, during gradual edema removal to normal hydration, and occasionally, to mild dehydration. The number of measure points was 113 in the nephrotic syndrome and 92 in renal failure. In both groups blood volume was normal at normal extracellular fluid volume (ECFV). Elevation of ECFV to 300% of normal in the nephrotic syndrome occurred with only a modest elevation of blood volume (NS). Elevation of ECFV to 200% of normal in the patients with renal failure was attended by a major elevation of blood volume (P < 0.01). Reduction of ECFV to about 10% below normal was accompanied by parallel blood volume reduction in both groups. Blood pressure was comparable at normohydration, and increased to clearly hypertensive levels only in the renal failure group with increasing ECFV and blood volume (P < 0.01). No major blood pressure difference was observed between normal and subnormal hydration, but hypotension was observed twice in the nephrotic group. Apparently, patients with severe hypoproteinemia due to the nephrotic syndrome are generally able to preserve their blood volume even when free of edema. However, their blood volume is not elevated in overhydration, in contrast to patients with renal failure who are normoproteinemic. This difference in regulation of extracellular fluid distribution is probably related to the hypoproteinemia, and its effect to reduce tissue—fluid protein.
- Subjects
BLOOD proteins; BLOOD plasma; BLOOD volume; BLOOD circulation; HEMODYNAMICS; BLOOD pressure; HOMEOSTASIS; PHYSIOLOGICAL control systems
- Publication
Kidney International, 1986, Vol 30, Issue 5, p730
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1038/ki.1986.248