Tuesday, 24 February 2015

PATHOGENESIS OF NEPHROTIC SYNDROME

In a normal kidney glomerulus doesn't let the proteins to get filtered because of the presence of 

  1. Tight junctions in the glomerular capillary wall
  2. Negative charge of GLOMERULAR BASEMENT MEMBRANE (proteins are also negatively charged)
  3. Presence of  PODOCYTES .  
If any one of these components gets damaged , it will lead to Nephrotic syndrome .


NEPHROTIC SYNDROME is a condition characterized by 
  1. Proteinuria 
  2. Hypoalbuminemia 
  3. Generalized edema
  4. Hyperlipidemia and Lipiduria

PATHOGENESIS:

  • When a damage of glomerular capillary wall or basement membrane or podocytes happen , proteins escape into the glomerular filtrate .
  • Thus it leads to proteinuria , primarily albumin is lost hence also called as albuminuria
  • Albumin level in blood decreases due to loss in urine leading to hypoalbuminemia
  • Due to Hypoalbuminemia there is fall in osmotic pressure leading to edema .
  • Due to hypoalbuminemia , liver tries to compensate the loss of albumin by increasing it's synthesis, On the process lipid synthesis gets triggered as well leading to HYPERLIPIDEMIAAlbumin is the carrier protein of lipid. Due to hypoalbuminemia there is abnormal lipid transport leading to LIPIDURIA.




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