Cause of nephrotic proteinuria
Proteinuria is a typical symptom of chronic kidney disease, the causes of albuminuria and glomerular barrier function has a close relationship. Proteinuria, glomerular capillaries are composed of three layers, from the inside layer of endothelial cells, respectively, the base film and the epithelial cell layer. As the cells are distributed in three layers of filter pore sizes and negative charge, so the barrier function of glomerular capillary can be divided in two, the mechanical barrier – barrier filter holes and the charge – a negative charge.
There are three main mechanisms to cause proteinuria:
Due to disease in glomerulus
Because of increased quantity of proteins in serum (overflow proteinuria)
Due to low reabsorbtion at proximal tubule (fanconi)
Proteinuria can also be caused by certain biological agents, such as bevacizumab (Avastin) used in cancer treatment.
1, the mechanical barrier – Scleral
Glomerular filtration barrier from the inside out by three components:
① Inner layer is the capillary endothelial cells. Endothelial cells have many small holes 50-100nm in diameter, called fenestrae (fenestration). Water, a variety of solutes and macromolecules can freely through the fenestrae of protein; but it prevents the blood cells through, playing the role of blood cell barrier.
② Middle of the base non-cellular membrane, was micro fiber network structure. Larger plasma molecules, such as basement membrane proteins cannot. Glomerular basement membrane is the filtration of protein molecules to prevent a major barrier.
③ Outer layer is the glomerular epithelial cells. Epithelial cells foot processes, cross-cutting fissure between the foot processes. Fissure cracks on a layer of membrane filtration (filtration slit membrane), membrane 4-14nm in diameter holes, which can prevent from the inside, the two proteins through the filter out of the macromolecules, is the final filtration barrier. Endothelial cells, basement membrane and the membrane constitute the fractured glomerular filtration membrane. Filtration membrane filtration channels of different sizes, so the small molecules can easily pass, the larger the effective radius of the material only through the larger channels, in general, the effective radius of less than 1.8nm material, can be completely filtered. Effective radius is larger than 3.6nm macromolecules, such as albumin (molecular weight of about 69,000) is almost totally filtered.
2, the charge barrier – the negative charge
Filtration membrane contains many layers of material with a negative charge, so the permeability of the membrane filtration is filtration material is also determined by the charge. The exclusion of the negatively charged material with negatively charged plasma proteins, limiting their filtration. Although the effective radius of serum albumin 3.5nm, but because of its negative charge, it is difficult through the filtration membrane. When a variety of pathological damage (including primary and secondary injury) on the kidneys, can cause partial damage to the kidney microcirculation, promote kidney (functional renal units) ischemia and hypoxia. Because ischemia, hypoxic injury of the glomerular capillary endothelial cells. Glomerular capillary endothelial cells, once damaged, it will attract circulating inflammatory cell infiltration, and release of inflammatory mediators of disease (IL-1, TNF – α, etc.) can cause pathological damage at this time impaired renal inflammatory response. Kidney in the pathological state, glomerular basement membrane (GBM) will be a series of changes: the increase or closed pore filtration, GBM fracture, the charge barrier damage, kidney permeability-increasing, negatively charged membrane filtration of sugar proteins decreased or disappeared, will lead to negatively charged than the normal plasma protein significantly increased filtration. Therefore, the formation of clinical proteinuria.
You may also be interested in:
French and U.S. scientists recently discovered that broccoli is not only rich
Tuberculosis, also known as tuberculosis, young people prone to a chronic
Appendicitis commonly known as appendicitis. Cecal appendix is near the head of
As the causes of acute appendicitis in children is not clear, in order to avoid
Insomnia is the inability of normal sleep, described the results obtained from
Colds are viruses diseases infected the upper respiratory tract and cold and
- Most Read
- Most Discussed
- Most Emailed
- Dietary treatment of chronic antral gastritis
- Tuberculosis, pneumonia, lung cancer, how to distinguish
- How to treat hepatic cysts
- Gastroptosis Symptoms
- Pyelonephritis diet and nursing
- The symptoms of gastric mucosa prolapse
- How do I care after appendectomy
- The symptoms of chronic antral gastritis
- Chinese medicine treatment "white hair"
- Modern treatment of chronic gastritis
Best of tcmwell.com
Bronchial asthma (asthma for short) is an attack of chest tightness, coughing,
Chinese medicine has long been awareness of the disease, in the "Huang Di Nei
Exogenous cough in acute upper respiratory tract infection, acute bronchitis
The slow progress of the disease is often recurrent, a good, middle-aged
Habitual abortion refers to pregnancy for women or 2 times 2 times more than
Understanding of the causes of high blood lipids Called diseases of modern
- is it normal for the testes to hang in between a man's legs
- Is this a normal penis behavior?
- How to resolve constipation
- How can Healthy Weight Loss?
- How to treat gastric ulcer
- Gastric cancer patients to eat?
- How to care for patients with H1N1
- What is the reason for infertility
- Impotence causes
- Cause stomach pain reasons
- This is a urethral stones do?
- How treatment of stroke ?
- I do not know what the reason for feet of swollen?
- Irregular menstruation should be how Conditioning?
- Finger joint pain is not arthritis?
- Wild Garlic Plants May Treating High Blood Pressure
- The prevention of chronic gastritis
- Understanding of the causes of hyperlipidemia
- Unexplained leukemia is a malignant disease
- Insomnia is the inability of normal sleep
- egg increases the risk of developing diabetes
- New Study Of Prescription
- American Ginseng Reduces Blood Sugar
- Chronic nephritis is a common and intractable of chronic kidney disease
- Appendicitis in children the disease the reasons
- chronic gastritis The diagnosis
- History of Traditional Chinese Medicine
- Urinary stone disease is a general term urinary tract lithiasis
- Snoring during pregnancy, may mean that diabetes
- chronic gastritis of Clinical manifestations