Glomerular dysfunction in nephrotic humans with minimal changes or focal glomerulosclerosis.
Glomerular dysfunction in nephrotic humans with minimal changes or focal glomerulosclerosis.
复制标题
肾病患者的肾小球功能障碍有微小变化或局灶性肾小球硬化。
DOI：
10.1152/ajprenal.1991.260.5.f728
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发表时间：
1991
期刊：
影响因子：
--
通讯作者：
Myers,BD
中科院分区：
文献类型：
--
作者：
Guasch,A;Hashimoto,H;Sibley,RK;Deen,WM;Myers,BD
不带电的右旋糖酐的分数清除率 (theta)（半径 28-60 A）用于表征 34 名患有微小病变肾病 (MCN) 或局灶性节段性肾小球硬化症 (FSGS) 的肾病患者的肾小球功能障碍。使用异孔膜模型对葡聚糖 θ 进行理论分析揭示了类似的改变，在 FSGS 中比 MCN 中更明显。穿过主要膜成分的限制性孔的数量与普遍的肾小球滤过率（GFR）同时减少。剩余膜组件中的平行分流孔更加突出，表明尺寸选择性受损。然而，这些分流引起的大 (60 A) 葡聚糖的 theta 仅在 FSGS 中超过了对照，表明电荷选择性的共存损害对 MCN 中的蛋白尿有重要贡献。当 MCN 缓解后，膜性能恢复正常。肾小球形态测量显示上皮滤过缝的频率随膜功能障碍的程度而变化。尽管抵消了 FSGS 中残余肾小球的肥大，但由于硬化导致的滤过表面损失可能导致该疾病中观察到的孔数量和 GFR 比 MCN 中更显着减少。
Fractional clearances (theta) of uncharged dextrans (radii 28-60 A) were used to characterize glomerular dysfunction in 34 nephrotic humans with either minimal-change nephropathy (MCN) or focal, segmental glomerulosclerosis (FSGS). A theoretical analysis of theta of dextran with a heteroporous membrane model revealed a similar alteration, more marked in FSGS than MCN. The number of restrictive pores perforating the major membrane component was reduced in parallel with the prevailing glomerular filtration rate (GFR). Parallel shuntlike pores in the remaining membrane component were more prominent, pointing to impaired size selectivity. However, the theta of large (60 A) dextrans attributable to these shunts exceeded control in FSGS only, suggesting that coexistent impairment of charge selectivity contributed importantly to the proteinuria in MCN. Membrane properties returned toward normal when MCN remitted. Glomerular morphometry revealed the frequency of epithelial filtration slits to vary with the extent of membrane dysfunction. Despite offsetting hypertrophy of remnant glomeruli in FSGS, a loss of filtration surface due to sclerosis likely contributed to the more marked reductions in pore number and GFR observed in this disorder than in MCN.