title: Sodium retention and volume expansion in nephrotic syndrome: implications for hypertension.
abstract: Sodium retention is a major clinical feature of nephrotic syndrome. The mechanisms responsible for sodium retention in this setting have been a subject of debate for years. Excessive sodium retention occurs in some individuals with nephrotic syndrome in the absence of activation of the renin-angiotensin-aldosterone system, suggesting an intrinsic defect in sodium excretion by the kidney. Recent studies have provided new insights regarding mechanisms by which sodium transporters are activated by factors present in nephrotic urine. These mechanisms likely have a role in the development of hypertension in nephrotic syndrome, where hypertension may be difficult to control, and provide new therapeutic options for the management of blood pressure and edema in the setting of nephrotic syndrome.
authors.affiliation: Renal Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; and Department of Cell Biology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Evan C
authors.initials: EC
authors.lastname: Ray
authors.affiliation: Renal Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; and Department of Cell Biology, University of Pittsburgh, Pittsburgh, PA. Electronic address: rondonberriosh@upmc.edu.
authors.forename: Helbert
authors.initials: H
authors.lastname: Rondon-Berrios
authors.affiliation: Renal Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; and Department of Cell Biology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Cary R
authors.initials: CR
authors.lastname: Boyd
authors.affiliation: Renal Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; and Department of Cell Biology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kleyman
mesh_terms: D053503:Epithelial Sodium Channels / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000378:metabolism*; D007668:Kidney / Q000378:metabolism*; D009404:Nephrotic Syndrome / Q000150:complications / Q000378:metabolism*; D011507:Proteinuria; D012964:Sodium / Q000378:metabolism*; D014883:Water-Electrolyte Imbalance / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*
chemical_list: D053503:Epithelial Sodium Channels; D012964:Sodium
keywords: Epithelial sodium channel; Nephrotic syndrome; Potassium sparing diuretics; Proteinuria; Serine proteases