BIOL 031 Lecture Notes - Lecture 28: Sepsis, Hemodynamics, Glomerular Basement Membrane
22 Dec 2020
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Pathophysiology of proteinuria & the nephrotic syndrome the basic definitions of proteinuria. It is normal to have up to 60mg/m2 body sa per day or ~100 mg/day. Protein excretion caused by: exercise, stress, norepinephrine, renin, and other stimuli. Observed proteinuria when a patient is upright (or lordotic position. No evidence to correlate this with significant renal disease. Many observed proteinuria readings when patient was in the supine position. Permissive filtration - facilitates passage of small molecules. Restrictive filtration - prevents the passage of larger molecules and solid elements in the blood. Need to pass the three layers of the capillary wall: Glycocalyx coats the endothelial layer and restricts filtration. Acts like gel electrophoresis ~35% of restriction. Nephrin is a transmembrane protein that interacts with other nephrin molecules in between adjacent podocytes. Smaller and more positive proteins (particles) have less filtration restriction. Size inhibition begins at a size of ~18 and completely inhibited at ~56 .
