Nephrosis

肾病
  • 文章类型: Journal Article
    本文介绍了与图库省食用Ludwigiapeploides有关的牛肾病暴发,阿根廷西北部。受影响的奶牛表现出颌下和胸部水肿,嗜睡和共济失调,最终屈服于这些条件。这些动物在这种植物严重入侵的可淹没区域放牧。该病影响了67头奶牛中的7头。在同一地点放牧的马和山羊没有受到影响。主要的大体和组织学病变对应于严重的肾病。这种疾病类似于哥伦比亚报道的Ludwigiaperuviana中毒。
    This paper describes an outbreak of nephrosis in cattle associated with the consumption of Ludwigia peploides in Tucuman province, northwestern Argentina. Affected cows exhibited submandibular and chest edema, lethargy and ataxia, and eventually succumbed to these conditions. These animals were grazing in a floodable area severely invaded by this plant. The disease affected 7 out of a herd of 67 cows. Horses and goats grazing in the same location were not affected. The main gross and histological lesion corresponded to a severe nephrosis. The disease is similar to the poisoning by Ludwigia peruviana reported in Colombia.
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  • 文章类型: Journal Article
    Secondary nephrosis is a series of chronic kidney diseases secondary to other underlying diseases, mainly manifesting as structural and functional abnormalities of the kidneys and metabolic disorders. It is one of the important causes of end-stage renal disease, with high morbidity and significant harm. Iron is an essential metal element in human cells, and ferroptosis is a non-traditional form of iron-dependent cell death, and its main mechanisms include iron accumulation, lipid metabolism disorders, abnormal amino acid metabolism, and damage to the antioxidant system. Recently studies have found that ferroptosis is involved in the occurrence and progression of secondary nephrosis, and the mechanism of ferroptosis in different secondary nephrosis vary. Therefore, an in-depth and systematic understanding of the association between ferroptosis and secondary nephrosis, as well as their specific regulatory mechanisms, can provide a theoretical basis for the diagnosis, prevention, treatment, and prognosis assessment of secondary nephrosis, laying the foundation for exploring new clinical therapeutic targets for secondary nephrosis.
    继发性肾脏病是继发于其他基础疾病的一系列慢性肾脏病,主要表现为肾结构和功能异常、代谢紊乱,是导致终末期肾病的重要原因之一,具有发病率高、危害大等特点。铁是人体细胞中必需的金属元素,铁死亡是一种非传统形式的、铁依赖性的细胞死亡,其主要机制包括铁蓄积、脂质代谢紊乱、氨基酸代谢异常和抗氧化系统损伤。近年研究发现铁死亡参与继发性肾脏病的发生、发展,不同继发性肾脏病中铁死亡的发生机制不同。深入、系统地了解铁死亡与继发性肾脏病之间的关联及其特异性调控机制,可为继发性肾脏病的诊疗、防治及预后评估提供理论依据,为探索继发性肾脏病新的临床治疗靶点奠定基础。.
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  • 文章类型: Journal Article
    移植前疫苗接种通常推荐给实体器官移植受者。在先天性肾病综合征(CNS)的婴儿中,由于年轻和尿中免疫球蛋白的丢失,免疫反应假设不如其他患者,但是关于严重肾病儿童免疫反应的数据仍然很少。如果有效,然而,在临床上对CNS婴儿进行早期免疫将是有利的.
    我们调查了在肾病期间免疫的7名中枢神经系统儿童的血清学疫苗反应。对麻疹-腮腺炎-风疹疫苗(MMR)的抗体反应,五价DTaP-IPV-Hib-疫苗(白喉,破伤风,无细胞百日咳,灭活脊髓灰质炎病毒,b型流感嗜血杆菌),水痘疫苗,甲型肝炎和乙型肝炎联合疫苗,和肺炎球菌结合疫苗(PCV)在肾移植之前或之后的肾切除术后进行测量。
    在中位年龄7个月[四分位距(IQR)7-8]开始免疫接种,并发中位蛋白尿为36,500mg/L(IQR30,900-64,250)。双侧肾切除术的中位年龄为20个月(IQR14-25),肾切除术后10-88天进行肾移植。在免疫后的中位18个月(IQR6-23)测量抗体水平。在所有接受检查的乙型肝炎儿童中检测到保护性抗体水平(5/5),破伤风梭菌(7/7),风疹病毒(2/2),和腮腺炎病毒(1/1);水痘5/6儿童;脊髓灰质炎病毒和疫苗型肺炎球菌血清型4/6;B型流感嗜血杆菌和白喉棒状杆菌4/7;麻疹病毒1/2;甲型肝炎2/5。
    严重的先天性蛋白尿期间的免疫导致可变的血清学反应,与疫苗和患者相关的差异。肾病似乎不是成功免疫的障碍。
    UNASSIGNED: Pretransplant vaccination is generally recommended to solid organ transplant recipients. In infants with congenital nephrotic syndrome (CNS), the immune response is hypothetically inferior to other patients due to young age and urinary loss of immunoglobulins, but data on the immunization response in severely nephrotic children remain scarce. If effective, however, early immunization of infants with CNS would clinically be advantageous.
    UNASSIGNED: We investigated serological vaccine responses in seven children with CNS who were immunized during nephrosis. Antibody responses to measles-mumps-rubella -vaccine (MMR), a pentavalent DTaP-IPV-Hib -vaccine (diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Haemophilus influenzae type b), varicella vaccine, combined hepatitis A and B vaccine, and pneumococcal conjugate vaccine (PCV) were measured after nephrectomy either before or after kidney transplantation.
    UNASSIGNED: Immunizations were started at a median age of 7 months [interquartile range (IQR) 7-8], with a concurrent median proteinuria of 36,500 mg/L (IQR 30,900-64,250). Bilateral nephrectomy was performed at a median age of 20 months (IQR 14-25), and kidney transplantation 10-88 days after the nephrectomy. Antibody levels were measured at median 18 months (IQR 6-23) after immunization. Protective antibody levels were detected in all examined children for hepatitis B (5/5), Clostridium tetani (7/7), rubella virus (2/2), and mumps virus (1/1); in 5/6 children for varicella; in 4/6 for poliovirus and vaccine-type pneumococcal serotypes; in 4/7 for Haemophilus influenzae type B and Corynebacterium diphtheriae; in 1/2 for measles virus; and in 2/5 for hepatitis A. None of the seven children had protective IgG levels against Bordetella pertussis.
    UNASSIGNED: Immunization during severe congenital proteinuria resulted in variable serological responses, with both vaccine- and patient-related differences. Nephrosis appears not to be a barrier to successful immunization.
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  • 文章类型: Journal Article
    背景:国际惯例指南提倡使用抗磷脂酶A2受体(PLA2R)抗体检测来诊断原发性膜性肾病(pMN)。本研究旨在阐明日本pMN诊断中抗PLA2R抗体测试的现状,并审查与实施该抗体测试相关的因素。
    方法:利用基于网络的肾病学家问卷,在2021年11月至2021年12月期间,从306家机构和427名肾脏病学家收集了回复。还研究了抗PLA2R抗体测试的偏好。与定量抗PLA2R抗体的经验有关的因素是通过广义估计方程,使用对隶属关系的设施簇进行方差的稳健分析来估计的。
    结果:在427名受访者中,140人(32.8%)在他们目前的工作场所有以前的测量经验,165人(38.6%)总体上有以前的测量经验。在没有肾活检禁忌症的pMN疑似病例中,147名(34.4%)受访者选择请求抗PLA2R抗体检测。在大学医院中,受访者在当前工作地点进行抗PLA2R抗体定量的经验通常较高,并且随着肾脏活检的年度数量和毕业后的年数而增加。
    结论:这项研究的结果表明,日本有很大一部分肾病学家没有进行抗PLA2R抗体测定的经验,并且分析可能会受到当前工作场所能力有限以及设施和患者的经济负担的阻碍。
    BACKGROUND: International practice guidelines advocate for the use of anti-phospholipase A2 receptor (PLA2R) antibody testing to diagnose primary membranous nephropathy (pMN). This study aimed to clarify the current status of anti-PLA2R antibody testing in the diagnosis of pMN in Japan and to scrutinize the factors associated with the implementation of this antibody test.
    METHODS: Utilizing a web-based questionnaire for nephrologists, responses were collected from 306 facilities and 427 nephrologists between November 2021 and December 2021. Preference for anti-PLA2R antibody testing was also investigated. Factors related to the experience of quantifying anti-PLA2R antibodies were estimated by generalized estimating equations using a robust analysis of variance with clusters of facilities of affiliation.
    RESULTS: Of the 427 respondents, 140 (32.8%) had previous measurement experience at their current workplace and 165 (38.6%) had previous measurement experience overall. In pMN-suspected cases without contraindications to renal biopsy, 147 (34.4%) of the respondents opted to request anti-PLA2R antibody testing. The respondents\' experience with anti-PLA2R antibody quantification at their current place of work was generally higher in university hospitals and increased with the annual number of kidney biopsies and the number of years since graduation.
    CONCLUSIONS: The results of this study suggest that a significant proportion of nephrologists in Japan have no experience in performing anti-PLA2R antibody assays, and that the assays may be hampered by the limited capabilities of the current workplace and the financial burden on facilities and patients.
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  • 文章类型: Journal Article
    SLK控制细胞骨架,细胞粘附,和移民。随着小鼠年龄的增长,小鼠中SLK的足细胞特异性缺失会导致足细胞损伤,并加剧实验性局灶性肾小球硬化(FSGS;阿霉素肾病)的损伤。我们假设粘附蛋白可能是SLK的底物。在阿霉素肾病中,SLK缺失夸大了足细胞超微结构损伤。蛋白激酶磷酸化位点数据集的分析表明,足细胞粘附蛋白-桩蛋白,维古林,和talin-1可以是潜在的SLK基底。在培养的足细胞中,SLK的缺失增加了对胶原的粘附。paxillin的分析,维古林,和talin-1表明SLK缺失减少了主要在阿霉素诱导的损伤中含有这些蛋白质的粘着斑复合物(FACs);FAC转换(粘着斑激酶Y397磷酸化)没有变化。在足细胞中,paxillinS250显示SLK略微增强的基础磷酸化;然而,SLK不磷酸化talin-1。在阿霉素肾病中,SLK缺失并不改变talin-1和vinculin的肾小球表达/定位,但适度增加粘着斑激酶磷酸化。因此,SLK降低足细胞粘附力,但足细胞中的FAC蛋白不是SLK在健康和疾病中的主要底物。
    SLK controls the cytoskeleton, cell adhesion, and migration. Podocyte-specific deletion of SLK in mice leads to podocyte injury as mice age and exacerbates injury in experimental focal segment glomerulosclerosis (FSGS; adriamycin nephrosis). We hypothesized that adhesion proteins may be substrates of SLK. In adriamycin nephrosis, podocyte ultrastructural injury was exaggerated by SLK deletion. Analysis of a protein kinase phosphorylation site dataset showed that podocyte adhesion proteins-paxillin, vinculin, and talin-1 may be potential SLK substrates. In cultured podocytes, deletion of SLK increased adhesion to collagen. Analysis of paxillin, vinculin, and talin-1 showed that SLK deletion reduced focal adhesion complexes (FACs) containing these proteins mainly in adriamycin-induced injury; there was no change in FAC turnover (focal adhesion kinase Y397 phosphorylation). In podocytes, paxillin S250 showed basal phosphorylation that was slightly enhanced by SLK; however, SLK did not phosphorylate talin-1. In adriamycin nephrosis, SLK deletion did not alter glomerular expression/localization of talin-1 and vinculin, but increased focal adhesion kinase phosphorylation modestly. Therefore, SLK decreases podocyte adhesion, but FAC proteins in podocytes are not major substrates of SLK in health and disease.
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  • 文章类型: Meta-Analysis
    尽管流行病学研究已经评估了环境空气污染与慢性肾脏疾病(CKD)之间的关系,结果喜忧参半。为了澄清协会的性质,我们进行了全面的系统评价和荟萃分析,以评估空气污染与CKD之间的全球关系.WebofScience,PubMed,系统搜索了Embase和Cochrane图书馆数据库,以查找截至2023年7月发表的研究,其中包括32项符合特定标准的研究。随机效应模型用于得出每种污染物的总体风险估计。对于PM2.5每增加10μg/m3,CKD风险的荟萃分析估计比值比(ORs)为1.42(95%置信区间[CI]:1.31-1.54);PM10每增加10μg/m3,则为1.20(95%CI:1.14-1.26);NO2每增加10μg/m3,1.07(95%CI:1.05-1.09)增加1.03:每1.07%1.亚组分析表明,这种影响因性别比例而异,年龄,研究设计,暴露评估方法,和收入水平。此外,PM2.5,PM10,即使在世界卫生组织推荐的可接受浓度范围内,NO2也对CKD产生负面影响。我们的结果进一步证实了空气污染对CKD风险的不利影响。这些发现有助于提高公共卫生官员和决策者对减少空气污染重要性的认识。
    Although epidemiological studies have evaluated the association between ambient air pollution and chronic kidney disease (CKD), the results remain mixed. To clarify the nature of the association, we conducted a comprehensive systematic review and meta-analysis to assess the global relationship between air pollution and CKD. The Web of Science, PubMed, Embase and Cochrane Library databases systematically were searched for studies published up to July 2023 and included 32 studies that met specific criteria. The random effects model was used to derive overall risk estimates for each pollutant. The meta-analysis estimated odds ratio (ORs) of risk for CKD were 1.42 (95% confidence interval [CI]: 1.31-1.54) for each 10 μg/m3 increase in PM2.5 ; 1.20 (95% CI: 1.14-1.26) for each 10 μg/m3 increase in PM10 ; 1.07 (95% CI: 1.05-1.09) for each 10 μg/m3 increase in NO2 ; 1.03 (95% CI: 1.02-1.03) for each 10 μg/m3 increase in NOX ; 1.07 (95% CI: 1.01-1.12) for each 1 ppb increase in SO2 ; 1.03 (95% CI: 1.00-1.05) for each 0.1 ppm increase in CO. Subgroup analysis showed that this effect varied by gender ratio, age, study design, exposure assessment method, and income level. Furthermore, PM2.5 , PM10 , and NO2 had negative effects on CKD even within the World Health Organization-recommended acceptable concentrations. Our results further confirmed the adverse effect of air pollution on the risk of CKD. These findings can contribute to enhance the awareness of the importance of reducing air pollution among public health officials and policymakers.
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  • 文章类型: Journal Article
    背景:尽管肾脏疾病推荐利妥昔单抗(RTX)作为原发性膜性肾病(pMN)的标准疗法之一,改善全球预后,考虑到保险范围的限制,目前还不清楚这种药物在日本是如何使用的。
    方法:这项横断面研究是在2021年11月至12月之间通过基于网络的调查进行的。参与者是经过认证的肾脏病学家,并通过便利抽样招募。将RTX用于pMN的经验与RTX用于微小变化性肾病综合征(MCNS)的经验进行比较。为pMN扣留RTX的原因,即使它被指示,也被调查了。此外,分析了RTX经验的比例差异。
    结果:分析了来自278家机构的380名肾病学家的反应。83例(21.8%)将RTX用于pMN,低于使用RTX进行MCNS的181人(47.6%)(比例:0.46)。在每年进行41-80和81或更多肾脏活检的设施中,RTX用于pMN的频率更高(与无)和具有抗PLA2R抗体测量经验的医生。PMN的RTX管理由56人(67.5%)的保险承保,是支付10英镑(12.0%)的设施费用,并由6例患者共同支付(7.2%)。为pMN扣留RTX的最常见原因是难以确保融资(146,79.3%)。
    结论:RTX用于pMN比用于MCNS更不常见,但并非罕见。在活检密集设施中,RTX治疗更为频繁,在五分之一的病例中,它由设施或患者全额支付。
    BACKGROUND: Although rituximab (RTX) is recommended by kidney disease improving global outcomes as one of the standard therapies for primary membranous nephropathy (pMN), given the constraint of insurance coverage, it is not clear how the drug is used in Japan.
    METHODS: This cross-sectional study was conducted via a web-based survey between November and December 2021. The participants were certified nephrologists and recruited through convenience sampling. Experience with RTX for pMN was compared to experience with RTX for minimal change nephrotic syndrome (MCNS). Reasons for withholding RTX for pMN, even when it is indicated, were also investigated. Furthermore, the proportion difference in RTX experience was analyzed.
    RESULTS: Responses from 380 nephrologists across 278 facilities were analyzed. RTX was used for pMN by 83 (21.8%), which was less than the 181 (47.6%) who had used RTX for MCNS (ratio of proportions: 0.46). RTX use for pMN was more frequent in facilities performing 41-80 and 81 or more kidney biopsies annually (vs. none) and by physicians with experience in anti-PLA2R antibody measurement. RTX administration for pMN was covered by insurance for 56 (67.5%), was facility-paid for 10 (12.0%), and was copaid by patients for 6 (7.2%). The most common reason for withholding RTX for pMN was difficulty in ensuring financing (146, 79.3%).
    CONCLUSIONS: RTX use for pMN is less common than for MCNS but not infrequent. Treatment with RTX was more frequent in biopsy-intensive facilities, and it was fully paid by the facility or patient in one-fifth of cases.
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  • 文章类型: Journal Article
    目的:先天性肾病综合征(CNS)是儿童终末期肾病的重要病因之一。基因型的研究,表型,基因突变引起的中枢神经系统婴儿的临床结局很少。
    方法:我们分析了遗传背景,临床表现,治疗反应,台湾儿科中枢神经系统患者的预后。
    结果:纳入了15名中枢神经系统婴儿,研究中纳入了来自10个无关家庭的基因突变导致的中位年龄21天(四分位距3~44天)的11例患者。在11名患者中,9例有肾外表现,包括小头畸形,面部畸形,和骨骼异常。超过三分之二的患者在1个月大之前发病。弥漫性脑膜硬化是最常见的组织学特征。全外显子组测序,然后直接Sanger序列显示OSGEP(R247Q)中的突变,WT1(R366H和R467Q),LAMB2(Q1209*和c.5432-545119bp缺失),NUP93(D302V),和LAGE3(c.188+1G>A)。其中三个变体是新颖的。2例患者服用皮质类固醇和/或免疫抑制剂,但两者都难以治疗。在平均3.5年的随访期间,除了两个人死于尿毒症和败血症.两名幸存者达到终末期肾病,需要腹膜透析,其中一人接受了顺利的肾移植。
    结论:台湾大多数中枢神经系统患者是由OSGEP和WT1突变引起的。R247Q是台湾OSGEP的热点突变。台湾的CNS患者具有显著的发病率和死亡率。
    OBJECTIVE: Congenital nephrotic syndrome (CNS) is one of the important causes of end-stage kidney disease in children. Studies on the genotype, phenotype, and clinical outcome in infants with CNS caused by genetic mutations are scarce.
    METHODS: We analyzed the genetic background, clinical manifestations, treatment response, and prognosis of pediatric patients with CNS in Taiwan.
    RESULTS: Fifteen infants with CNS were enrolled, and 11 patients of median age 21 (interquartile range 3∼44) days caused by genetic mutations from 10 unrelated families were included in the study. Of the eleven patients, 9 had extra-renal manifestations including microcephaly, facial dysmorphism, and skeletal anomalies. More than two-thirds of the patients had disease onset before 1 month of age. Diffuse meningeal sclerosis was the most common histological characteristic. Whole exome sequencing followed by direct Sanger sequence revealed mutations in OSGEP (R247Q), WT1 (R366H and R467Q), LAMB2 (Q1209∗ and c. 5432-5451 19 bp deletion), NUP93 (D302V), and LAGE3 (c.188+1G > A). Three of the variants were novel. Corticosteroids and/or immunosuppressants were administered in 2 patients, but both were refractory to treatment. During the mean 3.5 years of follow-up, all but two died of uremia and sepsis. The two survivors reached end-stage kidney disease and required peritoneal dialysis, and one of them underwent uneventful renal transplantation.
    CONCLUSIONS: The majority of patients with CNS in Taiwan were caused by OSGEP followed by WT1 mutation. R247Q is the hotspot mutation of OSGEP in Taiwan. CNS patients in Taiwan suffer from significant morbidity and mortality.
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  • 文章类型: Case Reports
    甲状旁腺功能减退,耳聋,肾发育不良(HDR)综合征是一种常染色体显性疾病。由于HDR综合征是由GATA3中的单倍体功能不全引起的,因此它在听力损失的发作和进展中表现出变化。在以前的报告中,自动听觉脑干反应(AABR)被认为不足以检测HDR综合征引起的感觉神经性听力损失.我们报告了一例HDR综合征,其先天性听力损失是通过使用AABR进行新生儿听力筛查(NHS)检测到的。在这种情况下,HDR综合征被怀疑是由于听力损失,低钙血症,和她的家族史.基因检测证实了5个月大的HDR综合征的诊断。由于HDR综合征引起的听力损失的表型是可变的,包括进行性听力损失,这些病例可能未被HNS检测到。然而,考虑到HDR综合征中听力损失并发症的发生频率,以前的大部分报告都是在NHS变得普遍之前发表的.我们认为NHS上有合理数量的HDR综合症病例异常。我们认为,NHS也可能有助于早期发现HDR综合征引起的听力损失。
    Hypoparathyroidism, deafness, and renal dysplasia (HDR) syndrome is an autosomal dominant disorder. Because HDR syndrome is caused by haploinsufficiency in GATA3, it exhibits variation in the onset and progression of hearing loss. In previous reports, the automated auditory brainstem response (AABR) was considered insufficient to detect sensorineural hearing loss caused by HDR syndrome. We report a case of HDR syndrome whose congenital hearing loss was detected by newborn hearing screening (NHS) using AABR. In this case, HDR syndrome was suspected due to hearing loss, hypocalcemia, and her family history. Genetic testing confirmed the diagnosis of HDR syndrome at 5 months of age. Because the phenotype of hearing loss due to HDR syndrome is variable and includes progressive hearing loss, these cases may not be detected by the HNS. However, most of the previous reports were published before the NHS became common and given the frequency of hearing loss complications in HDR syndrome. We consider that there is a reasonable number of HDR syndrome cases with abnormalities on the NHS. We believe that the NHS may also be useful for early detection of hearing loss due to HDR syndrome.
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  • 文章类型: Journal Article
    跨膜蛋白SLC22A17(或中性粒细胞明胶酶相关脂质运载蛋白(NGAL)/脂质运载蛋白2(LCN2)/24p3受体)是SLC22有机阴离子和阳离子转运蛋白家族的非典型成员:它不携带SLC22转运蛋白的典型底物,但介导LCN2的受体介导的内吞作用(RME)。肾脏的一项重要任务是通过在近端小管(PT)中通过megalin:cubilin:无羊膜介导的RME大量重吸收多种配体来预防肾小球过滤的蛋白质的尿丢失。因此,溢流,肾小球或PT损伤,就像范可尼综合征一样,导致蛋白尿。引人注目的是,在生理条件下,高达20%的过滤蛋白质逸出PT,并被远端肾单位重新吸收。肾脏远端小管和集合管表达SLC22A17,其介导逃避PT的过滤蛋白的RME,但在病理条件下预防蛋白尿的能力有限。肾脏还可以防止过滤的必需和非必需过渡金属(TM)的排泄,如铁(Fe)或镉(Cd),分别,很大程度上与高蛋白质结合,例如脂质运载蛋白-2(LCN2),转铁蛋白,或者金属硫蛋白,或低亲和力,例如微球蛋白或白蛋白。因此,TMs摄取增加可能引起肾毒性。在这里,我们评估了有关SLC22A17结构的文献,拓扑,组织分布,调节和假定的功能,强调肾脏SLC22A17,它与生理学相关,病理学,以及由于与TM复合的蛋白质积累而导致的肾毒性,例如Cd或Fe。SLC22A17的其他推定的肾功能,例如其对渗透应激适应的贡献,防止尿路感染,或肾癌,正在讨论。
    The transmembrane protein SLC22A17 [or the neutrophil gelatinase-associated lipocalin/lipocalin-2 (LCN2)/24p3 receptor] is an atypical member of the SLC22 family of organic anion and cation transporters: it does not carry typical substrates of SLC22 transporters but mediates receptor-mediated endocytosis (RME) of LCN2. One important task of the kidney is the prevention of urinary loss of proteins filtered by the glomerulus by bulk reabsorption of multiple ligands via megalin:cubilin:amnionless-mediated endocytosis in the proximal tubule (PT). Accordingly, overflow, glomerular, or PT damage, as in Fanconi syndrome, results in proteinuria. Strikingly, up to 20% of filtered proteins escape the PT under physiological conditions and are reabsorbed by the distal nephron. The renal distal tubule and collecting duct express SLC22A17, which mediates RME of filtered proteins that evade the PT but with limited capacity to prevent proteinuria under pathological conditions. The kidney also prevents excretion of filtered essential and nonessential transition metals, such as iron or cadmium, respectively, that are largely bound to proteins with high affinity, e.g., LCN2, transferrin, or metallothionein, or low affinity, e.g., microglobulins or albumin. Hence, increased uptake of transition metals may cause nephrotoxicity. Here, we assess the literature on SLC22A17 structure, topology, tissue distribution, regulation, and assumed functions, emphasizing renal SLC22A17, which has relevance for physiology, pathology, and nephrotoxicity due to the accumulation of proteins complexed with transition metals, e.g., cadmium or iron. Other putative renal functions of SLC22A17, such as its contribution to osmotic stress adaptation, protection against urinary tract infection, or renal carcinogenesis, are discussed.
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