Pathophysiology of proteinuria in diabetic glomerular disease.
Unchanged dextrans of graded size (28-60 A) were used to evaluate barrier size-selectivity in 56 proteinuric patients with diabetic glomerular disease. Transglomerular sieving was enhanced selectively for dextrans of greater than 46 A radius. A mathematical model of hindered solute transport through a porous membrane showed that this finding reflected the development in the glomerular barrier of a subset of enlarged, non-discriminatory pores. Although few in number, these enlarged pores accounted for both the magnitude and the composition of the observed proteinuria. We conclude that impaired barrier size-selectivity underlies the proteinuria of diabetic glomerular disease, and that impairment of barrier charge-selectivity need not be invoked in this circumstance.
Myers
B D
BD
Division of Nephrology, Stanford University School of Medicine, California 94305.
D001692:Biological Transport; D002199:Capillary Permeability; D003928:Diabetic Nephropathies / Q000503:physiopathology*; D005919:Glomerular Filtration Rate; D006801:Humans; D007678:Kidney Glomerulus / Q000098:blood supply / Q000503:physiopathology*; D010316:Particle Size; D011507:Proteinuria / Q000503:physiopathology*