Cargando…

Understanding the Mechanisms of Proteinuria: Therapeutic Implications

A large body of evidence indicates that proteinuria is a strong predictor of morbidity, a cause of inflammation, oxidative stress and progression of chronic kidney disease, and development of cardiovascular disease. The processes that lead to proteinuria are complex and involve factors such as glome...

Descripción completa

Detalles Bibliográficos
Autores principales: Toblli, Jorge E., Bevione, P., Di Gennaro, F., Madalena, L., Cao, G., Angerosa, M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398673/
https://www.ncbi.nlm.nih.gov/pubmed/22844592
http://dx.doi.org/10.1155/2012/546039
_version_ 1782238315804622848
author Toblli, Jorge E.
Bevione, P.
Di Gennaro, F.
Madalena, L.
Cao, G.
Angerosa, M.
author_facet Toblli, Jorge E.
Bevione, P.
Di Gennaro, F.
Madalena, L.
Cao, G.
Angerosa, M.
author_sort Toblli, Jorge E.
collection PubMed
description A large body of evidence indicates that proteinuria is a strong predictor of morbidity, a cause of inflammation, oxidative stress and progression of chronic kidney disease, and development of cardiovascular disease. The processes that lead to proteinuria are complex and involve factors such as glomerular hemodynamic, tubular absorption, and diffusion gradients. Alterations in various different molecular pathways and interactions may lead to the identical clinical end points of proteinuria and chronic kidney disease. Glomerular diseases include a wide range of immune and nonimmune insults that may target and thus damage some components of the glomerular filtration barrier. In many of these conditions, the renal visceral epithelial cell (podocyte) responds to injury along defined pathways, which may explain the resultant clinical and histological changes. The recent discovery of the molecular components of the slit diaphragm, specialized structure of podocyte-podocyte interaction, has been a major breakthrough in understanding the crucial role of the epithelial layer of the glomerular barrier and the pathogenesis of proteinuria. This paper provides an overview and update on the structure and function of the glomerular filtration barrier and the pathogenesis of proteinuria, highlighting the role of the podocyte in this setting. In addition, current antiproteinuric therapeutic approaches are briefly commented.
format Online
Article
Text
id pubmed-3398673
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher Hindawi Publishing Corporation
record_format MEDLINE/PubMed
spelling pubmed-33986732012-07-27 Understanding the Mechanisms of Proteinuria: Therapeutic Implications Toblli, Jorge E. Bevione, P. Di Gennaro, F. Madalena, L. Cao, G. Angerosa, M. Int J Nephrol Review Article A large body of evidence indicates that proteinuria is a strong predictor of morbidity, a cause of inflammation, oxidative stress and progression of chronic kidney disease, and development of cardiovascular disease. The processes that lead to proteinuria are complex and involve factors such as glomerular hemodynamic, tubular absorption, and diffusion gradients. Alterations in various different molecular pathways and interactions may lead to the identical clinical end points of proteinuria and chronic kidney disease. Glomerular diseases include a wide range of immune and nonimmune insults that may target and thus damage some components of the glomerular filtration barrier. In many of these conditions, the renal visceral epithelial cell (podocyte) responds to injury along defined pathways, which may explain the resultant clinical and histological changes. The recent discovery of the molecular components of the slit diaphragm, specialized structure of podocyte-podocyte interaction, has been a major breakthrough in understanding the crucial role of the epithelial layer of the glomerular barrier and the pathogenesis of proteinuria. This paper provides an overview and update on the structure and function of the glomerular filtration barrier and the pathogenesis of proteinuria, highlighting the role of the podocyte in this setting. In addition, current antiproteinuric therapeutic approaches are briefly commented. Hindawi Publishing Corporation 2012-07-04 /pmc/articles/PMC3398673/ /pubmed/22844592 http://dx.doi.org/10.1155/2012/546039 Text en Copyright © 2012 Jorge E. Toblli et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Toblli, Jorge E.
Bevione, P.
Di Gennaro, F.
Madalena, L.
Cao, G.
Angerosa, M.
Understanding the Mechanisms of Proteinuria: Therapeutic Implications
title Understanding the Mechanisms of Proteinuria: Therapeutic Implications
title_full Understanding the Mechanisms of Proteinuria: Therapeutic Implications
title_fullStr Understanding the Mechanisms of Proteinuria: Therapeutic Implications
title_full_unstemmed Understanding the Mechanisms of Proteinuria: Therapeutic Implications
title_short Understanding the Mechanisms of Proteinuria: Therapeutic Implications
title_sort understanding the mechanisms of proteinuria: therapeutic implications
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398673/
https://www.ncbi.nlm.nih.gov/pubmed/22844592
http://dx.doi.org/10.1155/2012/546039
work_keys_str_mv AT tobllijorgee understandingthemechanismsofproteinuriatherapeuticimplications
AT bevionep understandingthemechanismsofproteinuriatherapeuticimplications
AT digennarof understandingthemechanismsofproteinuriatherapeuticimplications
AT madalenal understandingthemechanismsofproteinuriatherapeuticimplications
AT caog understandingthemechanismsofproteinuriatherapeuticimplications
AT angerosam understandingthemechanismsofproteinuriatherapeuticimplications