Cause of proteinuria in patients with diabetic nephropathy

Diabetic nephropathy is one of the common chronic complications of diabetes. If the treatment is not timely, it can develop into renal failure, proteinuria is the main clinical manifestation, and the reason is related to a series of pathological changes caused by the disorder of glucose metabolism.
Glomerular hemodynamics
Glomerular hemodynamic abnormality was the initiating factor for diabetic nephropathy. Glucose metabolism disorder lead to a series of vasoactive factors of reaction of enhanced. These factors make glomerular afferent arteriole dilation, increased glomerular capillary blood flow, glomerular hyperfiltration, plasma albumin increased from filtration of capillary wall.
Function of glomerular filtration membrane
The glomerular filtration membrane is divided into 3 layers: endothelial cells, basement membrane and foot cell. The 3 layer structure of the filter membrane is mutually supported, there is active material exchange and mutual control. In diabetic nephropathy, the structure and function of glomerular filtration membrane are the main reasons for the formation of proteinuria.
Renal tubular lesions

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Under normal physiological conditions, most of the protein was absorbed by renal tubular, and only a few of the proteins were found in urine. In the case of diabetes, renal tubular epithelial cells proliferation is inhibited, which can induce renal tubular epithelial cells to differentiate into fibroblasts, loss of normal function, and reduce the loss of protein absorption.
Vascular endothelial growth factor

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Vascular endothelial growth factor (VEGF) is a role in a specific mitogen of endothelial cells, with a role in regulating angiogenesis and endothelial cell permeability. VEGF secretion increased, resulting in increased urinary protein excretion, urine protein excretion, urine protein.
Advanced glycation end products increased

Advanced glycation end products (AGEs) are the stable covalent compounds generated by proteins, lipids, nucleic acids and other large molecules that are spontaneously formed by the reaction of glucose or other reducing sugars with glucose or other conditions without enzyme. Hyperglycemia and ages in vivo and synthetic significantly increased advanced glycation end products (ages) so that the cycle of protein crosslinking and crosslinked albumin more leakage out of the filtration membrane is cause of urinary micro - albumin is one of the important reasons.