Mechanism and protein composition of proteinuria in pre-eclampsia

THE CONTEXT

The proposed mechanism of proteinuria combines glomerular endothelial injury with depressed tubular reabsorption.

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Spasm of the afferent glomerular arterioles causes anoxic changes in the endothelium of the glomerular tuft.

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These changes lead to glomerular endotheliosis, increased capillary permeability and increased protein leakage.

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Tubular reabsorption is simultaneously depressed.

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Albumin constitutes 50–60% of the urinary protein.

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The fraction identified as a-globulin constitutes 10–15%.

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