Division of Nephrology, Department of Medicine, Nephrology Research and Training Center, University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA.
J Am Soc Nephrol. 2012 Nov;23(11):1777-81. doi: 10.1681/ASN.2012040388. Epub 2012 Sep 20.
The tubular nephron is responsible for reabsorption and catabolism of filtered low molecular weight proteins that include Ig free light chains. In the setting of a plasma cell dyscrasia, significant amounts of free light chains, now monoclonal proteins, present to the tubular nephron for disposal. The result may be clinical renal dysfunction in the form of AKI, progressive CKD, and end-stage kidney disease. Here, I review the mechanisms involved in these processes that result in tubular injury, including proximal tubulopathy and cast nephropathy.
管状肾单位负责重吸收和分解滤过的低分子量蛋白质，包括免疫球蛋白游离轻链。在浆细胞异常的情况下，大量游离轻链（现为单克隆蛋白）被递送至管状肾单位进行处理。结果可能导致以急性肾损伤、进行性慢性肾脏病和终末期肾病为表现的临床肾功能障碍。在此，我综述了这些导致管状损伤的过程中的相关机制，包括近端肾小管病变和管型肾病。
