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Old 05-15-2015
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Default Minimal Change Disease

Does anyone know the mechanism behind the selectivity of albumin in the proteinuria associated with MCD?
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Old 05-16-2015
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Quote:
Originally Posted by sm3356 View Post
Does anyone know the mechanism behind the selectivity of albumin in the proteinuria associated with MCD?

Yes -- albumin is the most abundant protein in the blood. In most cases, albumin is the protein in proteinuria. It's also a fairly small protein and can pass through the glomerulus.

Also within the pathophysiology of MCD is the idea that you diminish the negative charge of the GBM. Usually, both albumin and the GBM have a negative charge which helps repel albumin and prevent it from passing, but as the charge is lost it's easier for alb to pass on through and ultimately into the urine.
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Old 05-16-2015
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is the loss of negative charge the same reason for proteinura in diabetic nephropathy?
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Old 05-16-2015
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One more thing that they like to test regarding this concept is the fact that GBM plus ENDOTHELIUM forms the charge barrier to plasma proteins. GBM plus EPITHELIUM podocytes form the SIZE barrier hence limit the particles based on size. It is the charge barrier that is lost in MCD. About diabetes, there is microfiltration due to GBM thickening caused by non enzymatic glycosylation of the GBM.

Last edited by Hassan8; 05-16-2015 at 07:02 PM.
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Old 05-16-2015
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Since the size barrier isnt lost i guess thats the reaon why very big proteins like immunoglobulins aren't filtered but smaller proteins like albumin can pass since the charge barrier is lost
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Old 05-17-2015
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Quote:
Originally Posted by sm3356 View Post
Does anyone know the mechanism behind the selectivity of albumin in the proteinuria associated with MCD?
3 Layers . Epithelium (size - 40nm)
Basement membrane (4nm)
Endothelium (Aka podocyte) (4nm with neg charge cuz of HEPARAN SULFATE(a glycosaminoglycan)

Albumin is 3.6nm. And its Negatively charged.

In MCD, podocytes(4nm) get FLATTENED(effaced) and loose the neg charge. Basement membrane(4nm) isnt lost even if podocytes are lost.

Albumin is near to the size of the endothelial gap. Hence selective
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