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Oedema is a side effect of all the 'glitozones'. Its cause is said to be multifactoral. The drugs cause an increase in plasma volume this may result from a reduction in renal excretion of sodium and an increase in sodium and free water retention. They may cause arterial vasodilatation, leading to sodium reabsorption with a subsequent increase in extracellular volume thereby resulting in peripheral oedema.Increased sympathetic nervous system activity, altered interstitial ion transport , alterations in endothelial permeability , and peroxisome proliferator-activated receptor-?-mediated expression of vascular permeability growth factor may represent other possible mechanisms for oedema.
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