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June 15, 1935


JAMA. 1935;104(24):2189-2190. doi:10.1001/jama.1935.02760240049017

Information concerning the chemical changes associated with the development of edema is being rapidly accumulated. These changes vary with the etiologic factors involved. In the extrarenal edema of nephrosis, for example, which Leiter1 reviewed a few years ago, several facts seem well established. Leiter summarized these "aphorisms" as follows: 1. All cases of active nephrosis present a significant proteinuria. 2. During the active stage, all cases of nephrotic edema present low total plasma proteins or low plasma albumin, and hence all present low protein osmotic pressure. 3. Nephrotic edema may disappear spontaneously or be absent in spite of albuminuria and low plasma proteins when the albumin-globulin ratio is high enough to give an osmotic pressure of the serum proteins above 20 cm. of water. 4. Nephrotic edema is more likely to yield to various diuretic measures when the plasma albumin is above than when it is below about 2

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