Raised venous pressure: a direct cause of renal sodium retention in oedema?

Lancet. 1988 May 7;1(8593):1033-5. doi: 10.1016/s0140-6736(88)91851-x.


Contemporary theories of oedema formation are often based on the idea that "effective" blood volume is reduced, and that sodium retention and oedema are a result of the kidney responding, as in haemorrhage, to a perception by receptors in the circulation that blood volume is inadequate. This idea has enhanced understanding of the pathophysiology of such conditions as cardiac failure and cirrhosis, but has obscured the fact that blood volume is almost always increased in oedematous states. Evidence is presented that an increase in renal venous pressure can cause sodium retention by a direct action on the kidney: a rise in venous pressure could thereby initiate a vicious circle by causing sodium retention, expansion of plasma volume, and further increase in venous pressure. This sequence of events may be crucial in the pathophysiology of cor pulmonale, and an exacerbating factor in other oedematous states.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Volume
  • Dogs
  • Edema / etiology
  • Edema / physiopathology*
  • Glomerular Filtration Rate
  • Heart Failure / complications
  • Heart Failure / physiopathology
  • Humans
  • Kidney / metabolism
  • Pericarditis, Constrictive / complications
  • Pericarditis, Constrictive / physiopathology
  • Pulmonary Heart Disease / complications
  • Pulmonary Heart Disease / physiopathology
  • Rats
  • Renal Circulation
  • Sodium / metabolism*
  • Venous Pressure*


  • Sodium