Kwashiorkor - New evidence in the puzzle of oedema formation.

Abstract

Kwashiorkor, a type of severe malnutrition associated with oedema, has been known for centuries but its mechanism remains elusive.1 The low level of plasma albumin and the associated decreased plasma oncotic pressure has been for years the main explanation of oedema of kwashiorkor: an excess fluid flow from the capillaries to the interstitium was assumed to result from an imbalance of Starling's forces.2 This mechanism seems plausible, as a low level of plasma albumin is a hallmark of kwashiorkor3 and the Starling's principle shows that plasma oncotic pressure, largely determined by plasma albumin, is amongst the factors influencing fluid flow from the capillaries towards the interstitium.