ArticleEBioMedicine2022
The role of albumin and the extracellular matrix on the pathophysiology of oedema formation in severe malnutrition.
Article in EBioMedicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 23 papers.
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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.
Randomized, Placebo Controlled Trial of Cotrimoxazole Prophylaxis Amongst HIV-uninfected Children With Severe Malnutrition
Randomized Controlled Trial of a Reduced Carbohydrate Formulation of F75 Therapeutic Milk Among Children With Severe Acute Malnutrition
Who cites it
23 citing papers in PubMed, 40 citations in OpenAlex.
- Comparison the effect of continuous and bolus enteral nutrition methods on serum albumin and prealbumin in critical ill patients: A randomized clinical trial.Journal of health, population, and nutrition · 2025Trial
- From Serum to Surgery: The Significance of Albumin in Preoperative Risk Stratification-An Analysis of 200,015 Plastic Surgery Patients.Aesthetic plastic surgery · 2026Article
- Association of serum albumin and obesity: Mediation effect of extracellular fluid, percent body fat and C-reactive protein.Medicine · 2026Article
- Interpretable machine learning model for predicting postoperative hypoproteinemia in middle-aged and elderly patients following total joint arthroplasty: a multicenter retrospective study.Frontiers in nutrition · 2026Article
- Sub-acute toxicity profiles of Rhoicissus tridentata as used in the traditional prostate cancer managment in the Elgon in Wistar albino rats.Scientific reports · 2025Article
- AI-driven discovery of novel extracellular matrix biomarkers in pelvic organ prolapse.PLoS computational biology · 2025Article
- Lactate-to-albumin ratio as an independent predictor of mortality in critically ill patients with gastrointestinal bleeding: a retrospective cohort study.BMC gastroenterology · 2025Article
- Dynamic association of serum albumin changes with inflammation, nutritional status and clinical outcomes: a secondary analysis of a large prospective observational cohort study.European journal of medical research · 2025Observational
- Association between albumin to Globulin ratio and pneumonia in patients with aneurysmal subarachnoid hemorrhage.Scientific reports · 2025Article
- Impact of fibrinogen-to-albumin ratio on the long-term prognosis of patients with advanced HER2-negative gastric cancer receiving immunochemotherapy.World journal of gastrointestinal oncology · 2025Article
- The Impact of Immunomodulatory Components Used in Clinical Nutrition-A Narrative Review.Nutrients · 2025Review
- Serum albumin combined with high-density lipoprotein cholesterol as a novel marker to predict coronary heart disease: are their associations multiplicative or rateable?Frontiers in cardiovascular medicine · 2025Article
- Bridging nutrition and neurology: malnutrition's role in perioperative neurocognitive disorders.Frontiers in nutrition · 2025Review
- Trajectories of resting energy expenditure and performance of predictive equations in children hospitalized with an acute illness and malnutrition: a longitudinal study.Scientific reports · 2024Article
- Article
- Inflammation: the driver of poor outcomes among children with severe acute malnutrition?Nutrition reviews · 2023Review
- Severe acute malnutrition promotes bacterial binding over proinflammatory cytokine secretion by circulating innate immune cells.Science advances · 2023Article
- Total 25-Hydroxyvitamin D Is an Independent Marker of Left Ventricular Ejection Fraction in Heart Failure with Reduced and Mildly Reduced Ejection Fraction.Biomolecules · 2023Article
- Associations of dietary, sociodemographic, and anthropometric factors with anemia among the Zhuang ethnic adults: a cross-sectional study in Guangxi Zhuang Autonomous Region, China.BMC public health · 2023Article
- Hypovolemia with peripheral edema: What is wrong?Critical care (London, England) · 2023Review
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Authors and funding
12 authors at 6 institutions in 4 countries.
Funding
Abstract
backgroundWhile fluid flows in a steady state from plasma, through interstitium, and into the lymph compartment, altered fluid distribution and oedema can result from abnormal Starling's forces, increased endothelial permeability or impaired lymphatic drainage. The mechanism of oedema formation, especially the primary role of hypoalbuminaemia, remains controversial. Here, we explored the roles of albumin and albumin-independent mechanisms in oedema formation among children with severe malnutrition (SM).
methodsWe performed secondary analysis of data obtained from two independent clinical trials in Malawi and Kenya (NCT02246296 and NCT00934492). We then used an unconventional strategy of comparing children with kwashiorkor and marasmus by matching (discovery cohort, n = 144) and normalising (validation cohort, n = 98, 2 time points) for serum albumin. Untargeted proteomics was used in the discovery cohort to determine plausible albumin-independent mechanisms associated with oedema, which was validated using enzyme-linked immunosorbent assay and multiplex assays in the validation cohort.
findingsWe demonstrated that low serum albumin is necessary but not sufficient to develop oedema in SM. We further found that markers of extracellular matrix (ECM) degradation rather than markers of EG degradation distinguished oedematous and non-oedematous children with SM.
interpretationOur results show that oedema formation has both albumin-dependent and independent mechanisms. ECM integrity appears to have a greater role in oedema formation than EG shedding in SM.
fundingResearch Foundation Flanders (FWO), Thrasher Foundation (15122 and 9403), VLIR-UOS-Ghent University Global Minds Fund, Bill & Melinda Gates Foundation (OPP1131320), MRC/DfID/Wellcome Trust Global Health Trials Scheme (MR/M007367/1), Canadian Institutes of Health Research (156307), Wellcome Trust (WT083579MA).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.