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Tubular Mechanisms in Proteinuria

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Abstract

Chronic progressive nephropathies, independent of the type of initial insult, are often associated with high levels of urinary protein excretion. In addition to well established glomerular role in proteinuria, recent studies have shown that proximal tubular cell plays important role in development of proteinuria both under physiologic and pathologic conditions. Many single-site mutations and complete PTC dysfunction result in a high level of albuminuria, without any histologic or electron microscopy structural alterations in the glomerular filtration barrier. Reabsorption of filtered albumin involves a low-capacity/high-affinity megalin-cubulin receptor-mediated process and a high-capacity/low-affinity, process that could be fluid-phase endocytosis. Future studies are warranted examining proteinuria not only as a glomerular impairment but also as proximal tubule dysfunction and may lead to many new advances in the diagnosis and treatment of proteinuric states.

Keywords

Kidney Proximal tubule cell Albuminuria Proteinuria 

Abbreviations

AKI

Acute kidney injury

AP1

Activator protein 1

BAD

Bcl-2 associated death promoter

BASP

Brain abundant signal protein 1

Bcl-2

B cell lymphoma 2

Bcl-xL

B-cell lymphoma-extra large

BMP

Bone morphogenic protein

DAMP

Danger-associated molecular patterns

DT

Diphtheria toxin

EGF

Epidermal growth factor

EMT

Epithelial-to-mesenchymal transition

ER

Endoplasmic reticulum

ERK

Extracellular signal related kinases

FADD

Fas associated protein with death domain

FcRn

Neonatal Fc receptor

FITC

Fluorescein isothiocyanate

HMG-CoA

3-hydroxy-3-methylglutaryl CoA

IgG

Immunoglobulin

IL

Inter-leukin

Kd

Dissociation constant

kD

Kilo dalton

MAP

Mitogen activated protein

MCP

Monocyte chemoattractant protein

MHC

Major histocompatibility complex

MWF

Munich-Wistar Fromter

NF-kB

Nuclear factor kappa-light chain-enhancer of activated B cells

NHE3

Na+/H+ exchanger isoform3

NLR

Nod like Receptor

NLRP3

NOD- like receptor family Pyrin domain containing 3

OK

Opossum kidney

PDGF

Platelet derived growth factor

PKB

Protein kinase B

PPAR

Peroxisome proliferator activated receptor

PT

Proximal tubule

PTC

Proximal tubular cell

RANTES

Regulated on activation normal T cell expressed and secreted

RAP

Receptor associated protein

RCT

Random control trial

TGF

Tumor growth factor

TIMP

Tissue inhibitors of metalloproteinases

TLR

Toll-like receptors

UTP

Uridine Tri-phosphate

α SMA

α-Smooth muscle actin

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.The Roudebush VA Medical Centre, Indiana Center for Biological MicroscopyIndiana University School of MedicineIndianapolisUSA

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