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Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of fluid...
Nephrotic Syndrome II : Assessment and Medical Management01:26

Nephrotic Syndrome II : Assessment and Medical Management

IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document any history...
Renal Corpuscle01:20

Renal Corpuscle

The glomerulus and Bowman's capsule are two essential components of the nephron, which is the functional unit of the kidney. These microscopic structures play a critical role in the process of blood filtration to produce urine.
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous capillaries...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
mTOR Signaling and Cancer Progression03:03

mTOR Signaling and Cancer Progression

The mammalian target of rapamycin or mTOR protein was discovered in 1994 due to its direct interaction with rapamycin. The protein gets its name from a yeast homolog called TOR. The mTOR protein complex in mammalian cells plays a major role in balancing anabolic processes such as the synthesis of proteins, lipids, and nucleotides and catabolic processes, such as autophagy in response to environmental cues, such as availability of nutrients and growth factors.
The mTOR pathway or the...
Renal Drug Excretion: Tubular Secretion01:28

Renal Drug Excretion: Tubular Secretion

Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...

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Related Experiment Video

Updated: Jul 18, 2026

Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
09:43

Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice

Published on: June 8, 2022

Sirolimus-associated proteinuria and renal dysfunction.

Gopala K Rangan1

  • 1Centre for Transplant and Renal Research, Westmead Millennium Institute, The University of Sydney at Westmead Hospital, Sydney, New South Wales, Australia. g.rangan@wmi.usyd.edu.au

Drug Safety
|December 7, 2006
PubMed
Summary

Sirolimus, an immunosuppressant, is effective in preventing kidney transplant rejection. However, it can cause proteinuria and renal dysfunction, especially in patients with pre-existing kidney damage.

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Mechanism of Kemeng Fang's Inhibition of Podocyte Apoptosis in Rats with Membranous Nephropathy through the PI3K/AKT Signaling Pathway

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Last Updated: Jul 18, 2026

Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
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Published on: August 23, 2024

Area of Science:

  • Nephrology
  • Immunology
  • Pharmacology

Background:

  • Sirolimus is a novel immunosuppressant targeting the mammalian target of rapamycin (mTOR).
  • It is a key therapeutic for preventing renal allograft rejection and chronic allograft nephropathy.
  • Sirolimus is considered 'non-nephrotoxic' due to lacking calcineurin inhibitor-associated vasomotor effects.

Purpose of the Study:

  • To investigate the association between sirolimus and renal adverse effects, specifically proteinuria and acute renal dysfunction.
  • To explore potential mechanisms and risk factors for sirolimus-induced nephrotoxicity.
  • To suggest strategies for minimizing these adverse effects in clinical practice.

Main Methods:

  • Review of clinical reports and existing literature on sirolimus use in renal patients.
  • Analysis of potential mechanisms including glomerular pressure, permeability, and cell proliferation.
  • Identification of risk factors such as pre-existing chronic renal damage.

Main Results:

  • Sirolimus use is linked to proteinuria and acute renal dysfunction in some patients, particularly those with prior kidney damage.
  • Potential mechanisms include increased glomerular pressure post-calcineurin inhibitor withdrawal and possible direct glomerular injury.
  • Acute renal dysfunction may stem from suppressed renal cell repair processes.

Conclusions:

  • Sirolimus-associated renal adverse effects can occur, necessitating careful patient selection and monitoring.
  • Strategies to mitigate risks include monitoring proteinuria and renal function, using ACE inhibitors/ARBs for proteinuria, and potential sirolimus withdrawal.
  • Further long-term studies are crucial to refine the understanding and management of sirolimus's renal effects.