Hyperlipidemia in nephrotic syndrome – Mechanism

Diabetes glomerulosclerosis with nephrotic syndrome – histopathology
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  • Nephrotic syndrome is characterised by albuminuria, hypoalbuminemia, oedema, hyperlipidemia and lipiduria
  • The increased loss of proteins in urine stimulates the liver to increase synthesis of proteins
  • Apolipoporteins are synthesised in increased quantities – especially apo B, apo C-II, and apo E which are used VLDL and LDL formation
  • Apoproteins associated with HDL synthesis – apo A-I and apo A-II usually remains normal
  • In addition to this, there is decreased lipid catabolism due to decreased activity of lipoprotein lipase
  • All these factors together contribute to the hyperlipidemic state in nephrotic syndrome
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