Edema in nephrotic syndrome is mainly due to:

c. Hypoalbuminemia(Ref: Nelson 20/e p 2521 and Harrison 19th ed/pg 253)Edema is the most common presenting symptom of children with nephrotic syndrome. Causes of Edema:In Nephrotic Syndrome: (primarily hypoalbuminemia)Primary alteration in the nephrotic syndrome is a diminished colloid oncotic pressure due to losses of largequantities (3.5g/day) of protein into the urineWith severe hypoalbuminemia and reduced colloid osmotic pressure, the sodium and water that are retained cannot be restrained within the vascular compartment, 50 total and effective arterial blood volumes declineThis process initiates the edema-forming sequence of events described above, including activation of the RAASIn Nephritic Syndrome:Edema that occurs associated with hematuria, proteinuria, and hypertensionAlthough some evidence supports the view that the fluid retention is due to increased capillary permeability, in most instances, the edema results from primary retention of sodium and water by the kidneys owing to renal insufficiency