Oncotic pressure, or colloid osmotic pressure, is a form of osmotic pressure exerted

by proteins, notably albumin, in a blood vessel's plasma (blood/liquid) that usually tends to
pull water into the circulatory system. It is the opposing force to hydrostatic pressure. It has a
major effect on the glomerular filter pressure.

Throughout the body, dissolved compounds have an osmotic pressure. Because large plasma
proteins cannot easily cross through the capillary walls, their effect on the osmotic pressure of the
capillary interiors will, to some extent, balance out the tendency for fluid to leak out of the
capillaries. In other words, the oncotic pressure tends to pull fluid into the capillaries. In
conditions where plasma proteins are reduced, e.g. from being lost in the urine (proteinuria) or
from malnutrition, there will be a reduction in oncotic pressure and an increase in filtration across
the capillary, resulting in excess fluid buildup in the tissues (edema).

The large majority of oncotic pressure in capillaries is generated by the presence of high
quantities of albumin, a protein that constitutes approximately 80% of the total oncotic pressure
exerted by blood plasma on interstitial fluid. The total oncotic pressure of an average capillary is
about 28 mmHg with albumin contributing approximately 22 mmHg of this oncotic pressure.
Because blood proteins cannot escape through capillary endothelium, oncotic pressure of
capillary beds tends to draw water into the vessels. It is necessary to understand the oncotic
pressure as a balance; because the blood proteins reduce interior permeability, less plasma fluid
can exit the vessel. [1]
Urine output The normal range for 24-hour urine volume is 800 to 2000 milliliters
per day (with a normal fluid intake of about 2 liters per day).
 Symptoms of peripheral edema include swelling of the affected area(s), which causes the
surrounding skin to "tighten." The swelling from peripheral edema is gravity-dependent (it will
increase or decrease with changes in body position). For example, if a person is lying on their
back (supine), the swelling will not appear in the legs, but will appear in the area around the
sacrum. The skin over the swollen area appears tight and shiny, and often when pressure is
applied to the area with a finger, an indentation appears. This is called pitting edema.

The cause of fluid leaking into the surrounding tissues may be the result of several
mechanisms, for example:

1. too much force, or pressure inside the blood vessels;

2. a force outside of the blood vessel causes the fluid to be drawn through it; or

3. the wall of the blood vessel is compromised and cannot maintainequilibrium, leading to fluid
loss.

- Pregnancy: Edema during pregnancy may occur because pregnantwomen have a greater
volume of fluid circulating in the body, and because they also retain more fluid. A woman may also
experience postpartum edema.

Medications: Edema may be caused by a variety of medications, for example, steroids,

calcium channel blockers (CCBs), thiazolidinediones, nonsteroidal antiinflammatory drugs
(NSAIDs), estrogens, etc.).

Liver disease and/or kidney disease: Both of these organs are vital in maintaining fluid
balance in the body, and if severe disease is present in either of these organ systems, edema can
develop. Examples include: cirrhosis of the liver, chronic kidney disease, and acute kidney failure.
 Venous insufficiency: This is a common condition in which blood does not return to the
heart efficiently from the peripheral areas of the body (for example, the ankles, legs, feet, hands),
which results in edema. This typically results in edema in both legs.

Heart failure: If the heart is weak and cannot pump blood efficiently, blood will pool in
particular areas of the body, which will cause fluid to leak from the blood vessels into the
surrounding tissues.

o If the right side of the heart is weak, pressure will build in the peripheral tissues in
the body (hands, ankles, feet, legs). This is referred to as peripheral edema.

o If the left side of the heart is weak, pressure will build in the lungs, causing
pulmonary edema.