Hypoproteinaemia, a menace to the blood volume?

In hypoproteinaemia, tissue fluid proteins are redistributed to the blood. On the one hand, this adaptive change preserves the transcapillary oncotic gradient, but on the other it implies that an important oedema-preventing mechanism is being exhausted. The implications for regulation of the blood volume in hypoproteinaemia are that: (1) blood volume is not necessarily below normal, whether or not oedema is present and (2) blood volume is hardly or not at all increased when fluid has been retained; conversely, blood volume does not fall when oedema is removed from a hypoproteinaemic patient. In severe hypoproteinaemia, the transcapillary oncotic gradient cannot be maintained because the tissue fluid protein pool becomes exhausted. In this case, a fall in blood volume leads to functional hypovolaemia and renal volume retention. The plasma oncotic pressure below which this can be expected, probably lies somewhere below 11 mm Hg for a (recumbent) human being. On theoretical grounds, such secondarily retained fluid can be expected to accumulate exclusively in the interstitial space. Consequently, the blood volume is not restored and hypovolaemic symptoms remain despite oedema. The question is, therefore, justified: can hypoproteinaemia in itself ever be a contraindication to oedema-reducing treatment?