Question

Ellen, who is a 47-year-old woman, has suffered kidney disease for several years. She has been diagnosed with high concentration of plasma protein in her urine (aka proteinuria). Her legs and feet are so swollen that she has difficulty walking. Her hands and her left arm are also swollen. What's going on?

a. She is suffering hypotensive (low blood pressure).

b. She is suffering hypoproteinemia (low concentration of plasma proteins in blood) because of being hypertensive.

c. She is suffering hyperproteinemia (high concentration of plasma proteins in blood) because of her change in diet.

d. She has a decreased sodium reabsorption rate by her renin-angiotensin-aldosterone mechanism is blocked.

Answer 1

b. She is suffering from hypoproteinemia because of she is hypertensive

Proteinuria is consequence of two mechanisms:

1.Abnormal transglomerular passage of proteins due to increased pressure in glomerular capillaries due to hypertension which increases permeability of glomerular capillary wall their subsequent impaired reabsorption by the epithelial cells of the proximal tubuli.

The increased load of such proteins in the tubular lumen leads to the saturation of the reabsorptive mechanism by the tubular cells, and, in chronic conditions that favors the increased urinary excretion of all proteins, including low-molecular-weight proteins, which are completely reabsorbed in physiologic conditions that lead to proteinuria