Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China.
Adv Exp Med Biol. 2019;1165:487-500. doi: 10.1007/978-981-13-8871-2_24.
Proteinuria is identified as an important marker and risk factor of progression in chronic kidney disease. However, the precise mechanism of action in the progress of chronic kidney disease is still unclear. Mesangial toxicity from specific filtered compounds such as albumin-bound fatty acids and transferrin/iron, tubular overload and hyperplasia, and induction of proinflammatory molecules such as MCP-1 and inflammatory cytokines are some of the proposed mechanisms. Reversing intraglomerular hypertension with protein restriction or antihypertensive therapy may be beneficial both by diminishing hemodynamic injury to the glomeruli and by reducing protein filtration. Therefore, understanding proteinuria and its role in renal tubular interstitial inflammation and fibrosis is of great significance for the study of renal protective therapy, such as antiproteinuric treatments, and delaying the progression of chronic renal disease.
蛋白尿被确定为慢性肾脏病进展的一个重要标志物和风险因素。然而，慢性肾脏病进展的确切作用机制仍不清楚。某些特定滤过化合物（如白蛋白结合脂肪酸和转铁蛋白/铁）引起的系膜毒性、小管超负荷和增生，以及促炎分子如 MCP-1 和炎症细胞因子的诱导，是一些被提出的机制。通过限制蛋白质或降压治疗来逆转肾小球内高血压，可能通过减少肾小球的血流动力学损伤和减少蛋白质滤过而获益。因此，了解蛋白尿及其在肾小管间质炎症和纤维化中的作用，对于研究肾脏保护治疗（如抗蛋白尿治疗）和延缓慢性肾脏病进展具有重要意义。
