From the Research
Renal Hypoperfusion and Proteinuria
- Renal hypoperfusion can lead to proteinuria, as stated in the study 1, which suggests that severe renal artery stenosis can cause proteinuria by hyperfiltration.
- The "underfill" theory proposes that edema is secondary to salt retention resulting from renal hypoperfusion, which can occur in the context of massive proteinuria 1.
- However, the relationship between renal hypoperfusion and proteinuria is complex, and proteinuria can have various causes, including glomerular diseases, tubulointerstitial diseases, and vascular disorders 2, 3, 4, 5.
Mechanisms of Proteinuria
- Proteinuria can result from the abnormal transglomerular passage of proteins due to increased permeability of the glomerular capillary wall and their subsequent impaired reabsorption by the epithelial cells of the proximal tubuli 3.
- The glomerular filtration barrier plays a crucial role in preventing the abnormal passage of albumin and high-molecular-weight proteins, and its dysfunction can lead to proteinuria 2, 4.
- Tubular protein concentrations can be toxic to tubular cells and contribute to the progression of chronic renal disease 4.
Clinical Implications
- Proteinuria is a strong marker for progression of chronic kidney disease and increased cardiovascular morbimortality 2.
- The evaluation of proteinuria is essential for the diagnosis of renal disease, and its quantitative and qualitative assessment can provide valuable information about the underlying causes and prognosis 5.
- Therapy for proteinuria depends on the underlying cause and may involve specific treatments for glomerular diseases, as well as symptomatic management of edema and other complications 1.