Abstract
The article informs about current views of the pathogenesis and treatment of generalised edema. Edema is ordinarly defined as an abnormal accumulation of extravascular intersticial fluid of sufficient magnitude to be clinically detectable.
The initiating event appers to be a decrease in the effective intravascular volume. One of several of the homeostatic efector mechanisms involved in the regulation of the sodium excretion are then activated, leading to the retention of sodium and water.
What distingishes the edematous patient from the normal is that the usual renal homeostatic response to extracelular expansion does not occure. The ideal approach to the management of edema is correction of the underlying disease process, but unfortunately this objective more often than cannot be fully realised.
Dietary restriction of sodium salts value in the control of extracellular volume expansion and in rare instances may be sufficient in itself to prevent the excessive accumulation of edema fluid and one must turn to natriuretic drugs. Use of thiazide diuretics, furosemide, spironolactone and amiloride is briefly presented as well as complications and limitations to the treatment with diuretic drugs.