As we all know, proteinuria is a very common symptom of nephrotic syndrome,
but how many people are there know the reason why lots of proteinuria
exists.
Water and solute in blood enter renal capsule via glomerulus to become
initial urine, this process must through the endothelial cells , basement
membrane of capillary wall and epithelial cells. These three layer structures
are called the glomerular filtration membrane. All of the three filtration
membranes have certain holes, which only allows the materials that have certain
molecular weight and molecular diameter to pass, so they are the size barrier of
filtration membranes. The surfaces of three layer structures are covered by
silaoprotein, and glomerular basement membrane inside and outside loose layer
have rich heparan sulfate, these substances take negative charge in fluid
environment, so they reject the solutes that take negative charge to pass, then
the charge barrier of filtration membranes forms.
In addition, the intraglomerular mesangium which lies among glomerular
capillaries has a regulating action to filtration barrier of glomerulus, so also
has a certain effect to the filtration of glomerulus. Under the normal
circumstances, most of the protein in blood can not go through the filtration
barrier of glomerulus, especially the macromolecules and the albumins that take
negative charge almost completely can not go through, a small amount of small
molecule proteins which had gotten through filtration can be reabsorbed by
kidney tubules, so protein expelled from urine is less than 150mg.
At the time of nephrotic syndrome, barrier function of filtration membrane is
destroyed by a variety of pathogenic factors, the holes become bigger and
negative charge decreases, which leads to the leakage of a large amount of
protein, it outdistance the ability of reabsorption of kidney tubules, so a
great quantity of proteinuria appears.
For nephrotic syndrome patients, they also have hypoalbuminemia because of
the loss of lots of protein. So they should arrange their diet reasonably and
find a good method to solve this problem from the origin.
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