The effect of statins on podocytes in nephrotic syndrome

Czech version

Authors: Peter Habara ^1,3; Marie Claire Šmůlová ¹; Pavla Fialová ¹; Jan Krtil ^2,3; Karolína Krátká ³; Ivan Rychlík ³
Authors‘ workplace: Centrální laboratoře, úsek klinické biochemie FNKV, Praha ¹; Ústav biochemie a laboratorní diagnostiky 1. LF UK a VFN v Praze ²; I. interní klinika FNKV a 3. LF UK, Praha ³
Published in: AtheroRev 2019; 4(3): 145-152
Category:

Overview

Nephrotic syndrome frequently accompanies glomerulnephritides, including diabetic nephropathy and obestity-induced glomerulopathy, which are marked by pathology at the level of the podocyte. Podocytes are the main cellular component of renal parenchyme facilitating the filtration of blood not only through the inherent structural component they provide the glomerular filtration membrane itself, but also through their active role in regulating it. In the last few years, the pathophysiology of podocytes has been studied extensively as well as their role as a potential diagnostic tool. In light of this, it has been determined that the presence of podocytes in urine correlates to a state of active renal disease leading to nephrotic sydnrome, the consequences of which can be severe. That is to say, in the setting of nephrotic sydrom resistant to treatment, the threat of progressive disease culminating in in end-stage renal failure is high as well the damaging systemic effects of the resulting metabolic disruption. Dyslipidemia, coagulopathy and changes to the renin-angiotensin-aldosterone system are the most studied metabolic disturbances associated with nephrotic syndrome. In all of thesesituations, compensatory mechanisms to restore homeostasis are engaged, which can become dangerously damaged in wake of the accelerateddevelopment of atherosclerotic changes and their ensuing complications, due to a prolonged state of disease. Statins--especially their pleiotropic effects-offer promising therapeautic potential, which needs to be further explored and utilized more extensively in the clinical setting.

Keywords:

combination therapy – Atherosclerosis – podocyte – podocalyxin – statins – dyslipidemie

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