ReviewPaediatrics and international child health2015
Oedema in kwashiorkor is caused by hypoalbuminaemia.
Review in Paediatrics and international child health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Influence of Malnutrition on the Pharmacokinetics of Drugs Used in the Treatment of Poverty-Related Diseases: A Systematic Review.Clinical pharmacokinetics · 2021Pooled it
- Assessing Clinical Severity and Prognosis in Adolescents With Anorexia Nervosa and Atypical Anorexia Nervosa Using the Albumin-Globulin Ratio.European eating disorders review : the journal of the Eating Disorders Association · 2026Article
- Genome wide transcriptional changes underlie gradual and recurrent adaptation to protein malnutrition in zebrafish.PLoS genetics · 2026Article
- Hypovolemic Shock in the Setting of Third Spacing with Concentric Left Ventricular Hypertrophy: A Physiology-Guided Management of Fluid Resuscitation-Case Report and Literature Review.Pathophysiology : the official journal of the International Society for Pathophysiology · 2026Article
- Review
- Inhibition of SREBP-1c rescues hepatic CYP7B1 expression and bile acid synthesis in malnourished mice.American journal of physiology. Gastrointestinal and liver physiology · 2025Article
- A New Murine Undernutrition Model Based on Complementary Feeding of Undernourished Children Causes Damage to the Morphofunctional Intestinal Epithelium Barrier.The Journal of nutrition · 2024Article
- Inflammation: the driver of poor outcomes among children with severe acute malnutrition?Nutrition reviews · 2023Review
- First Clinical Nutrition Outpatient Consultation: A Review of Basic Principles in Nutritional Care of Adults with Hematologic Disease.TheScientificWorldJournal · 2023Review
- Anasarca as a manifestation of childhood volvulus: Diagnostic and management challenges in an 11-year old Nigerian boy.Caspian journal of internal medicine · 2023Article
- Kwashiorkor - New evidence in the puzzle of oedema formation.EBioMedicine · 2022Article
- The role of albumin and the extracellular matrix on the pathophysiology of oedema formation in severe malnutrition.EBioMedicine · 2022Article
- [Infant with generalized edema and a skin rash].Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete · 2022Article
- Severe Protein-Calorie Malnutrition-Associated Hepatic Steatosis in a Woman Who Had Roux-en-Y Gastric Bypass for Morbid Obesity Thirteen Years Ago.Gastroenterology research · 2021Article
- Secondary Kwashiorkor Disease in a Patient with Gastric Bypass Surgery and Short Gut Syndrome.The American journal of case reports · 2021Article
- Coagulopathy in Malnourished Mice Is Sexually Dimorphic and Regulated by Nutrient-Sensing Nuclear Receptors.Hepatology communications · 2020Article
- An infant with kwashiorkor: The forgotten disease.Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia · 2020Article
- Interprofessional Management of Median Arcuate Ligament Syndrome (Dunbar Syndrome) Related to Lumbar Lordosis and Hip Dysplasia: A Patient's Perspective.European journal of case reports in internal medicine · 2020Article
- Predictors of in-hospital mortality among under-five children with severe acute malnutrition in South-Western Uganda.PloS one · 2020Article
- Lysosome-Rich Enterocytes Mediate Protein Absorption in the Vertebrate Gut.Developmental cell · 2019Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
It has been argued that the oedema of kwashiorkor is not caused by hypoalbuminaemia because the oedema disappears with dietary treatment before the plasma albumin concentration rises. Reanalysis of this evidence and a review of the literature demonstrates that this was a mistaken conclusion and that the oedema is linked to hypoalbuminaemia. This misconception has influenced the recommendations for treating children with severe acute malnutrition. There are close pathophysiological parallels between kwashiorkor and Finnish congenital nephrotic syndrome (CNS) pre-nephrectomy; both develop protein-energy malnutrition and hypoalbuminaemia, which predisposes them to intravascular hypovolaemia with consequent sodium and water retention, and makes them highly vulnerable to develop hypovolaemic shock with diarrhoea. In CNS this is successfully treated with intravenous albumin boluses. By contrast, the WHO advise the cautious administration of hypotonic intravenous fluids in kwashiorkor with shock, which has about a 50% mortality. It is time to trial intravenous bolus albumin for the treatment of children with kwashiorkor and shock.
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