Nephrotic Syndrome is a condition in which the filters of the kidneys become leaky and large amount of protein is spilt into the urine. This kidney disease is featured with protein in urine (>3.5g/day), low blood protein levels, hypercholesterolemia, high triglyceride levels, and tissue swelling. This text mainly talk about the pathogenesis of hypercholesteromia in this disorder.
What is Hypercholesterolemia?
This condition refers to the presence of high levels of cholesterol in the
blood. It is not a disease but a metabolic derangement that can be secondary to
many disease. People affected by this condition are likely to develop other
diseases, such as cardiovascular disease.
It is closely associated with the terms"hyperlipidemia"(elevated levels of
lipids) and "hyperlipoproteinemia" (elevated levels of lipoproteins)
Pathogenesis of Hypercholesterolemia in NS.
Individuals with kidney disease often have abnormal lipid metabolism. Both
increased synthesis and decreased clearance of lipoproteins may contribute to
the hyperlipoproteinemia which frequently complicates the NS with increased
levels of total and low-density lipoprotein (LDL) cholesterol as the most
Hyperlipoproteinemia may also be featured with high triglycerides levels,
increased concentrations of Apo B, Apo C, Apo E and decreased levels of Apo A-I
Increased lipoprotein synthesis happens in partly undefined mechanisms
associated with urine protein, low blood protein levels and, possibly, and more
mevalonate (as a substrate for cholesterol synthesis).
Urinary loss of high-density lipoprotein (HDL) components and other
lipo-regulatory factors can cause reduced activity of lipolytic enzymes, leading
to damaged clearance of cholesterol- and triglyceride-rich lipoproteins of lower
densities and altered composition of HDL.
Due to the variability in the above two metabolic abnormalities,
corresponding variability in lipoprotein profiles of people with NS occur as a