The risk of proteinuria in patients with nephrotic syndrome2017-09-27 16:59
In patients with nephrotic syndrome, the main symptom is a large number of urine protein, urine protein is not only due to the loss of a large number of protein, and urinary protein in glomerular and renal tubular will cause damage, resulting in renal fibrosis. The occurrence of urinary protein is the first independent risk factor for uremia. The greatest hazard of urine protein is that it can destroy the kidneys and cause uremia. So, what are the specific hazards of urine protein?
Urinary membrane toxicity of urine protein: in renal failure model, can be observed in the accumulation of serum protein in mesangium, aggregation of these macromolecules in the mesangial area can cause mesangial cell damage, proliferation of the mesangial matrix increased synthesis, resulting in glomerulosclerosis. In the nephrotic model, urinary proteins contain low density lipoprotein and very low density lipoprotein apolipoprotein B as well as apolipoprotein A deposits, which eventually lead to glomerulosclerosis.
The toxic effects of urinary protein in proximal tubule cells: when urinary protein, protein in renal tubular epithelial cells into lysosomes increased, the activity increased, suggesting that the lysosomal protein spilled into the tubular cytoplasm, subsequent cell injury can stimulate inflammation and scar formation.
Biological changes in tubular cells caused by urine proteins: in general, many renal diseases with proteinuria appear to have an overgrowth of cells, which represents a non adaptive response that can lead to kidney failure. More and more evidence that the protein can be directly regulating tubular cell function, change the growth characteristics and phenotypic expression of cytokines and matrix protein, can lead to the release of PDGF and FN tubular basement side and MCP-1 induced fibrosis.
Urinary protein causes tubulointerstitial hypoxia: Proteinuria reabsorption, digestion of large amounts of protein requires extra energy, can cause tubular cells hypoxia, resulting in tubular cell damage.