B charge of the substance the sialoproteins contained

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B) CHARGE OF THE SUBSTANCE - THE SIALOPROTEINS CONTAINED IN THE GLOMERULAR FILTRATION LAYER ARE NEGATIVELY CHARGED. THEREFORE ALL NEGATIVELY CHARGED PARTICLES INCLUDING PROTEINS ARE REPELLED BY FILTRATION LAYER. 24
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IN SOME RENAL PATHOLOGY THE ANIONIC CHARGE OF THE FILTRATION MEMBRANE IS LOST AND THIS ALLOWS NEGATIVELY CHARGED PARTICLES TO PASS THROUGH IT. THIS IS WHY THE PROTEINS WHICH ARE NEGATIVELY CHARGED START APPEARING IN THE RENAL DISEASES, (PROTEINURIA). “ALBUMIN HAS THE SMALLEST MOLECUALR WEIGHT AND SIZE OUT OF ALL THE PLASMA PROTEINS THEREFORE IT IS PARTICULARLY SUSCEPTIBLE TO BE FILTERED VIA GLOMERULAR FILTER”. THE DIAMETER OF ALBUMIN MOLECULE IS 7NM AND THE GLOMERULAR FILTRATION LAYER ALLOWS PARTICLES OF DIAMETER 8NM TO PASS THROUGH IT. THE ALBUMIN STARTS APPEARING IN URINE AS SOON AS THE NEGATIVE CHARGE OF FILTRATION LAYER DISAPPEARS. 25
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IN RENAL DISEASE, ALBUMIN IS FIRST TO APPEAR IN URINE BECAUSE - (AIIMS MAY 04) A) OF ITS HIGH CONCENTRATION IN PLASMA B) HAS MOLECULAR WEIGHT SLIGHTLY LESSER THAN THE MOLECULES NORMALLY GETTING FILTERED C) HIGH ALBUMIN: GLOBULIN RATIO D) TUBULAR EPITHELIAL CELLS ARE SENSITIVE TO ALBUMIN ANS. IS ‘B’ 26
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Q) GLOMERULAR RANGE PROTEINURIA DIFFERENTIATED BY NON GLOMERULAR PROTEINUREA BY - (PGI JUNE 05) A) PROTEINURIA > 3.0-3.5 G/DAY B) GLOBULIN > ALBUMIN C) ALBUMIN TO BETA-2 MICROGLOBULIN RATIO 100:1 D) TAMM HORSFALL PROTEIN 27
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PROTEIN PRESENT IN THE PLASMA IS PREVENTED FROM FILTERING AT TWO STAGES: AT THE GLOMERULUS (FILTRATION BARRIER):- THE CHARGE AND THE SIZE SELECTIVITY OF THE FILTRATION BARRIER PREVENTS THE FILTRATION OF PLASMA ALBUMIN, GLOBULIN AND OTHER LARGE MOLECULAR WEIGHT PROTEIN FROM CROSSING THE GLOMERULAR WALL. SMALLER PROTEINS ARE FREELY FILTERED FROM THE GLOMERULUS. 28
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IN THE TUBULES:- THE SMALLER PROTEIN FILTERED FROM THE GLOMERULUS ARE REABSORBED IN THE TUBULES (THESE PROTEINS ARE BETA2 MICROGLOBULINS, APOPROTEINS, ENZYME AND PEPTIDE HORMONES). NORMAL INDIVIDUAL EXCRETE <150 MG/D OF TOTAL PROTEIN PER DAY WHICH CONSISTS OF SMALL PROTEIN EASILY FILTERED AT THE GLOMERULUS E.G. BETA 2 MICROGLOBULIN, APOPROTEINS, ENZYMES AND HORMONES AND PROTEINS SECRETED BY THE TUBULES (TAMM-HORSFALL, IGA AND UROKINASE). 29
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MAGNITUDE OF THE PROTEINURIA AND THE PROTEIN COMPOSITION IN THE URINE DEPENDS UPON THE MECHANISM OF RENAL INJURY LEADING TO PROTEIN LOSSES 30
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Q) GLOMERULAR RANGE PROTEINURIA DIFFERENTIATED BY NON GLOMERULAR PROTEIN UREA BY - (PGIJUNE 05) A) PROTEINURIA > 3.0-3.5 G/DAY B) GLOBULIN > ALBUMIN C) ALBUMIN TO BETA-2 MICROGLOBULIN RATIO 100:1 D) TAMM HARSFALL PROTEIN ANS. IS ‘A’ I.E., PROTEINURIA > 3.0 - 3.5 G/D [REF: HARRISON 18"‘/E P. 338, 339; 1 ?H/E P. 1785] THE MAGNITUDE OF PROTEINURIA AND THE PROTEIN COMPOSITION IN THE URINE DEPENDS UPON THE MECHANISM OF RENAL INJURY LEADING TO PROTEIN LOSSES.
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