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Edema

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Pediatric Nephrology Review
Frank Tenney MD
Allergic, cardiac, cirrhotic, nephrotic, and nephritic edema states are discussed below. Expanded discussions of nephrotic and nephritic edema may be found, with links to recent articles reviewing the other types of edema.
Cardiac Edema
Cirrhotic Edema
Allergic Edema

Renal Edema

Nephrotic Syndrome
Nephritic Syndrome
Cases
Articles of interest (PDF):
A unifying hypothesis...
E&M Proteinuria/Nephrotic Syndrome
Link:
Nephrotic Syndrome
Images and Diagrams
The acute nephritic syndrome is the sudden onset of hematuria, either gross or microscopic; proteinuria; decreased GFR; occasionally oliguria; and retention of salt and water, which may be associated with edema, circulatory volume overload, and hypertension.
The hallmark of this syndrome is hematuria and red blood cell casts in the urine, with only minimal to moderate proteinuria.
Acutely decreased GFR may result from decreased filtration surface area caused by cellular proliferation, endothelial swelling, and neutrophil infiltration; from inflammation-mediated local vascular changes that decrease net filtration pressure; and from obstruction of Bowman's space by fibrin deposition and crescent formation.
The mechanism for salt and water retention is understood poorly. It may occur without changes in serum albumin concentration and often is out of proportion to the decrease in GFR.
Nephrotic Syndrome (NS) is a clinical condition resulting from the loss of large amounts of protein from the blood into the urine. Usually, the amount of proteinuria is sufficient to cause hypoproteinemia and consequent edema. This hypoalbuminemia is associated with decreases in effective renal perfusion and an increase in tubular reabsorption of salt and water.
Thus, in a manner analogous to that of congestive heart failure, the kidney continues to maximize its reabsorption of salt and water in a physiologic setting in which total body fluid is increased.
The NS may be a feature of any form of childhood GN or may be secondary to other systemic diseases, nephrotoxins, or allergic reactions.