Effects of kwashiorkor malnutrition on measured capillary filtration rate in forearm.

This study investigated the effects of kwashiorkor malnutrition on blood tissue fluid exchange by measuring the rate of capillary filtration (CFR) in response to a 60-mmHg increment in venous pressure in the forearms of 1- to 3-yr-old native African children within the Transkei Homeland. They were divided into the following subject groups: kwashiorkor patients (K); kwashiorkor patients who were at various stages of recovery (RK); marasmus patients (M); patients with edema of nonkwashiorkor origin (E); and control children (C). Measurements of CFR were significantly lower in the K subjects compared with any of the other groups (P less than 0.05), whereas, the RK, M, E, and C subjects were not significantly different from each other. This latter finding indicates that the lower CFR of the K patients is reversible and is not due to malnutrition or edema per se. Measurements of forearm cutaneous blood flow by laser Doppler flowmetry (LDF) in C and K subjects showed only a slightly lower value for the K patients (P greater than 0.20), and there was no relationship between CFR and LDF for either group (r = 0.073). These results suggest that the lower CFR of the K patients is not secondary to peripheral vasoconstriction.