Wiwanitkit Viroj
Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
J Diabetes Complications. 2007 May-Jun;21(3):164-5. doi: 10.1016/j.jdiacomp.2005.11.001.
In diabetes, the appearance of albumin in the urine has long been recognized as a cardinal feature of kidney disease. Physiologically, the glomerular capillary wall provides a barrier to protein in blood not to cross into urine. However, in the pathological condition, the change in the glomerular permeability, protein can be detected in urine. Here, the author reviewed the reported size of the glomerular pore size as well as the molecular size of glucose and albumin in the literature. According to this study, it can conclude that the appearance of glucosuria in diabetic patient is due to the impairment of renal tubular function. With prolonged glucosuria, the impairment of glomerulus, decrease in pore size, develops. Finally, the albuminuria occurs as late complication.
在糖尿病中,尿中出现白蛋白长期以来一直被认为是肾脏疾病的主要特征。生理上,肾小球毛细血管壁对血液中的蛋白质起到屏障作用,使其不会进入尿液。然而,在病理状态下,肾小球通透性发生改变,尿液中可检测到蛋白质。在此,作者回顾了文献中报道的肾小球孔径大小以及葡萄糖和白蛋白的分子大小。根据这项研究,可以得出结论,糖尿病患者出现糖尿是由于肾小管功能受损。随着糖尿持续存在,肾小球会出现损伤,孔径减小。最终,蛋白尿作为晚期并发症出现。