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What are the dangers of proteinuria in nephrotic syndrome?

In patients with nephrotic syndrome, is a symptom of the most 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. Studies have shown that the occurrence of urinary protein is the first independent risk factor for uremia. The biggest hazard of urine protein is that it can destroy the kidneys and cause uremia. So, what are the dangers of urine proteinuria in nephrotic syndrome?
Firstly, mesangial toxicity of urinary protein, renal failure in the 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 protein contains low density lipoprotein (LDL) and very low density lipoprotein (VLDL) apolipoprotein B and apolipoprotein A deposits, and these aggregates eventually lead to glomerulosclerosis.
Secondly, the toxic effects of urinary protein of proximal tubular cells, when the incidence of 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.
Thirdly, the biological changes of tubular cells induced by urinary protein. 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.
Finally, proteinuria results in increased tubulointerstitial hypoxia. Urinary protein reabsorption, digestion of large amounts of protein requires extra energy, can cause tubular cells hypoxia, resulting in tubular cell damage.

What are the dangers of proteinuria in nephrotic syndrome?
What are the dangers of proteinuria in nephrotic syndrome?

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