Editing Kwashiorkor (section)

=== Peripheral edema and hypoalbuminemia ===
Kwashiorkor is a form of protein deficiency, which can result in both osmotic imbalances and irregularities in the lymphatic system.<ref name="Pham Alou Golden et al 2021"/>

Kwashiorkor is most notable for peripheral edema. The presence of edema in kwashiorkor is correlated with very low albumin concentration ([[hypoalbuminemia]]). Edema results from a loss of fluid balance between the hydrostatic and oncotic pressures across the capillary blood vessel walls<ref name="Benjamin & Lappin Kwashiorkor"/> due to the lack of protein which affects the body's ability to draw fluid from the tissues into the bloodstream. Low albumin concentration influences negatively the strength of oncotic pressure. Failure leads to fluid buildup in the abdomen, resulting in edema and belly distension.<ref name="Pham Alou Golden et al 2021"/>

Furthermore, the release of antidiuretic hormone is stimulated by hypovolemia, also leading to the development of peripheral edema. Plasma [[renin]] is also stimulated, promoting sodium retention.<ref name="Benjamin & Lappin Kwashiorkor">{{cite book |last1=Benjamin |first1=Onecia |last2=Lappin |first2=Sarah L. |chapter=Kwashiorkor |id={{NCBIBook2|NBK507876}} |title=StatPearls |date=2022 |publisher=StatPearls Publishing |pmid=29939653 }}</ref>

It is important to distinguish the pathophysiology of marasmus and kwashiorkor when it comes to treating malnourished children who may have hypovolemic shock that is caused by an acute loss of salt and water.<ref name="G. Coulthard 2015">{{cite journal |last1=G. Coulthard |first1=Malcolm |title=Oedema in kwashiorkor is caused by hypoalbuminaemia |journal=Paediatrics and International Child Health |date=13 May 2015 |volume=35 |issue=2 |pages=83–89 |doi=10.1179/2046905514Y.0000000154 |pmid=25223408 |pmc=4462841 }}</ref> Children with severe albumin deficiency struggle physiologically to maintain their blood volume.<ref name="G. Coulthard 2015"/>