Mizdrak Maja, Smajic Bozo, Mizdrak Ivan, Ticinovic Kurir Tina, Kumric Marko, Paladin Ivan, Batistic Darko, Bozic Josko
Department of Internal Medicine, University Hospital of Split, 21000 Split, Croatia.
Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia.
Biomedicines. 2024 Aug 15;12(8):1860. doi: 10.3390/biomedicines12081860.
Nephrotic syndrome is a clinical syndrome characterized by massive proteinuria, called nephrotic range proteinuria (over 3.5 g per day in adults or 40 mg/m per hour in children), hypoalbuminemia, oncotic edema, and hyperlipidemia, with an increasing incidence over several years. Nephrotic syndrome carries severe morbidity and mortality risk. The main pathophysiological event in nephrotic syndrome is increased glomerular permeability due to immunological, paraneoplastic, genetic, or infective triggers. Because of the marked increase in the glomerular permeability to macromolecules and the associated urinary loss of albumins and hormone-binding proteins, many metabolic and endocrine abnormalities are present. Some of them are well known, such as overt or subclinical hypothyroidism, growth hormone depletion, lack of testosterone, vitamin D, and calcium deficiency. The exact prevalence of these disorders is unknown because of the complexity of the human endocrine system and the differences in their prevalence. This review aims to comprehensively analyze all potential endocrine and hormonal complications of nephrotic syndrome and, vice versa, possible kidney complications of endocrine diseases that might remain unrecognized in everyday clinical practice.
肾病综合征是一种临床综合征，其特征为大量蛋白尿，即肾病范围蛋白尿（成人每天超过3.5克，儿童每小时每平方米体表面积超过40毫克）、低白蛋白血症、渗透压性水肿和高脂血症，且发病率在数年间呈上升趋势。肾病综合征具有严重的发病风险和死亡风险。肾病综合征的主要病理生理事件是由于免疫、副肿瘤、遗传或感染性触发因素导致肾小球通透性增加。由于肾小球对大分子的通透性显著增加以及白蛋白和激素结合蛋白随之出现的尿中丢失，出现了许多代谢和内分泌异常。其中一些异常是众所周知的，如显性或亚临床甲状腺功能减退、生长激素缺乏、睾酮缺乏、维生素D缺乏和钙缺乏。由于人类内分泌系统的复杂性及其患病率的差异，这些疾病的确切患病率尚不清楚。本综述旨在全面分析肾病综合征所有潜在的内分泌和激素并发症，反之亦然，分析内分泌疾病在日常临床实践中可能未被认识到的潜在肾脏并发症。
