Pathophysiology and etiology of edema in adults
- Richard H Sterns, MD
Richard H Sterns, MD
- Editor-in-Chief — Nephrology
- Section Editor — Fluid and Electrolytes
- Professor Emeritus
- University of Rochester School of Medicine and Dentistry
- Section Editor
- Michael Emmett, MD
Michael Emmett, MD
- Editor-in-Chief — Nephrology
- Section Editor — Fluid and Electrolytes
- Chief of Internal Medicine
- Baylor University Medical Center
- Deputy Editors
- Daniel J Sullivan, MD, MPH
Daniel J Sullivan, MD, MPH
- Deputy Editor — Primary Care (Adult)
- Assistant Professor of Medicine
- Harvard Medical School
- John P Forman, MD, MSc
John P Forman, MD, MSc
- Senior Deputy Editor — UpToDate
- Deputy Editor — Nephrology
- Assistant Professor of Medicine
- Harvard Medical School
Edema is defined as a palpable swelling produced by expansion of the interstitial fluid volume. A variety of clinical conditions are associated with the development of edema, including heart failure, cirrhosis, and the nephrotic syndrome (table 1).
Some patients have localized edema. This can be caused by a variety of conditions, including venous obstruction, as occurs with deep vein thrombosis or venous stasis, and allergic reactions (such as laryngeal edema).
This topic will review the pathophysiology and etiology of generalized edematous states. The clinical manifestations, diagnosis, and therapy of edema are discussed separately. (See "Clinical manifestations and diagnosis of edema in adults" and "General principles of the treatment of edema in adults" and "Treatment of refractory edema in adults".)
PATHOPHYSIOLOGY OF EDEMA FORMATION
There are two basic steps involved in edema formation:
●An alteration in capillary hemodynamics that favors the movement of fluid from the vascular space into the interstitium
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- PATHOPHYSIOLOGY OF EDEMA FORMATION
- Capillary hemodynamics
- Edema formation
- - Increased capillary hydraulic pressure
- - Hypoalbuminemia
- - Increased capillary permeability
- - Lymphatic obstruction (lymphedema)
- - Myxedema
- Compensatory factors
- Renal sodium retention
- The compensated state
- Heart failure
- Drug-induced edema
- Refeeding edema
- INFORMATION FOR PATIENTS