2014年12月30日星期二

The cause of proteinuria

Proteinuria is a symptom of chronic renal failure, why? What causes proteinuria?

Under normal circumstances, glomerular filtration membrane filtration effective pore radius of about 30 angstroms. When a molecular weight above 000 6-70 substances through the filtration membrane is difficult. A molecular weight of 69,000 plasma albumin radio molecular approximately 37 angstroms, it is difficult to enter the urine, only small molecular weight lysozyme, β2-microglobulin, immunoglobulin light chain may be of glomerular filtration .Meanwhile urine, the membrane glomerular basement proteins rich in sialic acid, a negative to the surface to form a layer of plasma proteins although some small molecular weight, however, with a negative charge, repel each other, filtered and urine, serum load serum albumin under the conditions of pH was 7.42, showing a state of negative charge, and therefore is hard to pass. In addition to tubular proteinuria was not selective reabsorption.

Since glomerular diseases, glomerular filtration membrane or barrier load is damaged, there will be a large number of plasma proteins in urine leak, resulting in high levels of protein in urine of normal. Common in acute and chronic glomerulonephritis, glomerular nephropathy, secondary glomerular diseases such as diabetic nephropathy, lupus nephritis, renal amyloidosis, and so on.

Pathological urinary protein in addition to glomerular proteinuria, there tubular proteinuria, overflow proteinuria, renal proteinuria. The tubular proteinuria is due to pathological conditions, the tubular reabsorption of the most common dysfunction caused protein in tubular and interstitial diseases. Overflow proteinuria is due to pathological conditions, the plasma protein molecules some large increase, and exceeds the capacity of tubular reabsorption in the urine, the formation of proteinuria. More common in multiple myeloma, severe crush injuries and other diseases. Proteinuria in renal tissue proteins refers to kidney tissues or urine in kidney tissue in a condition of urinary protein excretion.

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