ALBUMIN KINETICS IN EDEMATOUS AND NONEDEMATOUS PROTEIN-ENERGY MALNOURISHED CHILDREN

The kinetic changes responsible for decreased plasma albumin and the r elation between plasma albumin and the edema of protein-energy malnutr ition (PEM) were investigated by measuring the plasma concentration, f ractional (FSR) and intravascular absolute (ASR) synthesis rates of al bumin in seven edematous and seven nonedematous children with PEM by u sing constant intragastric infusions of [H-2(3)]leucine. Studies were done 2 d postadmission (study 1), 8 d postadmission (study 2), and at recovery (study 3). In study 1 there were no significant differences i n plasma albumin concentrations in nonedematous and edematous children . In both groups, albumin concentrations but not FSRs were lower in st udies 1 and 2 than in study 3. The ASR was lower only in edematous pat ients. These results suggest that repletion of the albumin pool of chi ldren with PEM is not mediated by changes in the FSR, and the edema of malnutrition is not solely due to hypoalbuminemia.