nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2019-23-4-96-111nefr-1728Research ArticleПРОГРАММА НЕПРЕРЫВНОГО ПОСЛЕДИПЛОМНОГО ОБРАЗОВАНИЯ ПО НЕФРОЛОГИИPROGRAM ON CONTINUOUS POSTGRADUATE EDUCATION ON NEPHROLOGYНарушения клубочкового фильтрационного барьера как причина протеинурии при нефротическом синдромеDisorders of club filtration barrier as the cause of proteinuria in the nephrotic syndromehttps://orcid.org/0000-0002-8101-103XЗверевЯ. Ф.ZverevYa. F.

Зверев Яков Федорович - докор медицинских наук, профессор, кафедра фармакологии.

656038, Барнаул, пр. Ленина, д. 40, Тел.: 8(3852)566-891

Yakov F. Zverev - MD, DMedSci, Prof., Department of Pharmacology.

656038, Barnaul, Lenin avenue, 40, Phone: 8(3852)566-891

zver@agmu.ruhttps://orcid.org/0000-0002-5889-7071РыкуноваА. Я.RykunovaA. Ya.

Рыкунова Анна Яковлевна - кандидат медицинских наук, кафедра криминалистики.

656038, Барнаул, ул. Чкалова, д. 49, Тел.: 8 (3852) 379-163

Anna Ya. Rykunova - MD, PhD, Department of Criminology.

656038, Barnaul, Chkalov st., 49, Phone: 8(3852)379163

zveranna@mail.ruАлтайский государственный медицинский университетРоссияAltai State Medical UniversityRussian FederationБарнаульский юридический институтРоссияBarnaul Law InstituteRussian Federation20192306201923496111Copyright © Зверев Я.Ф., Рыкунова А.Я., 20192019Зверев Я.Ф., Рыкунова А.Я.Zverev Y.F., Rykunova A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/1728

Обзор посвящен причинам и механизмам возникновения протеинурии при различных заболеваниях, сопровождающихся развитием нефротического синдрома. Проанализирован вклад повреждений основных компонентов клубочкового фильтрационного барьера, включая эндотелий клубочковых капилляров, гломерулярную базальную мембрану и подоциты. Показано, что индукция протеинурии может быть следствием нарушений структуры и функции каждого из названных слоев фильтра, как и его комбинированного повреждения. Уделено особое внимание роли гликокалик-са и его составляющих, а также активных форм кислорода и эндотелиального фактора роста в патогенезе нарушений селективной проницаемости эндотелия капилляров почечных клубочков при болезни минимальных изменений, фокально-сегментарном гломерулосклерозе, преэклампсии, диабетогенной нефропатии. Обсуждается значимость таких генетических нарушений гломерулярной мембраны, как синдромы Пирсона, Альпорта. Отдельно рассматриваются также генные мутации, обусловливающие нарушения структуры и функционирования основных белков актино-вого цитоскелета подоцитов.

The review is devoted to the causes and mechanisms of proteinuria in various diseases associated with the development of the nephrotic syndrome. The contribution of damage to the main components of the glomerular filtration barrier, including the endothelium of glomerular capillaries, glomerular basement membrane, and podocytes, was analyzed. It is shown that the induction of proteinuria may be a consequence of disorders of the structure and function of each of these layers of the filter, as well as its combined damage. Special attention is given to the role of the glycocalyx and its components as well as reactive oxygen species and endothelial growth factor in the pathogenesis of disorders of the selective permeability of the capillary endothelium of the glomeruli in minimal change disease, focal segmental glomerulosclerosis, pre-eclampsia, diabetogenic nephropathy. The significance of such genetic disorders of the glomerular membrane as Pearson and Alport syndromes is discussed. Gene mutations causing disorders of the structure and functioning of the main proteins of the actinic cytoskeleton of podocytes are considered separately.

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The authors declare that there are no conflicts of interest present.