Patient's question:
I have been experiencing frequent urination with mild pain during urination recently. I often feel overall discomfort, dizziness, fatigue, and lower back and sacral soreness. I went to the hospital for a thorough examination, and the results showed nephrotic syndrome with a large amount of protein in the urine.Hello: What are the causes of nephrotic syndrome with a large amount of protein in the urine?
Doctor's answer:
The changes in the permeability of the glomerular basement membrane are the fundamental cause of proteinuria in nephrotic syndrome, including alterations in the charge barrier and the pore size barrier. Additionally, the ability of renal tubular epithelial cells to reabsorb protein from the glomerular filtrate and metabolize it also contributes to the formation of proteinuria. The amount of urinary protein is also influenced by factors such as plasma concentration and glomerular filtration rate. Severe reduction in plasma albumin can decrease the excretion of urinary protein. Conversely, intravenous infusion of purified protein preparations can temporarily enhance the excretion of urinary protein. The effect of glomerular filtration rate on urinary protein excretion is evident in non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme inhibitors, which increase urinary protein excretion by 40–60% by interfering with glomerular perfusion and transmembrane pressure.