proteinuria of greater than 3.

5 grams in 24 hours
dyslipidemia (hypercholesterolemia)
hypoalbuminemia
peripheral edema or edema

the nephron the Bowman's capsule which is the head of the nephron the glomerulus is a group of vessels that
come from the afferent arteriole which is bringing blood into the nephron and the blood vessels leaving the
nephron is the efferent arteriole which later will essentially form the renal vein to understand the product
syndrome and the different types we need to revise the anatomy of the head of the nephron so let us cut a
cross section of the glomerulus and the Bowman's capsule to orientate ourselves the head of the nephron
itself is made up of special cells called parietal cells and these are essentially squamous epithelial cells which
forms the Bowman's capsule in the Bowman's capsule is the glomerulus the group of blood vessels that are all
wind up together the vessels are made of of fenestrated endothelium which allow for filtration surrounding the
fenestrated endothelium is the glomerular basement membrane then surrounding the basement membrane are
cells called podocytes with their foot projections the podocytes are important because in a way they help
with the filtering process they help by maintaining the integrity and structure of the glomerulus then of course
around the vessel around the podocytes you have the Bowman's capsule which houses the glomerulus so you
can say the deepest layer is the fenestrated endothelium or of the vessel which contains you know within it the
blood and other blood stuff and moving out so going to the next layer we have the glomerular basement
membrane or GBM then we have the putter site at its foot projections the Bowman's capsule and finally the
parietal cells that houses the glomerulus let us pull one of these vessels out and as you can see the putter
sites are surrounding it with the foot projections then below it is the glomerular basement membrane and then
the fenestrated endothelium the most inner layer and within the blood vessel we can find proteins and we can
find red blood cells another important cell in this area are the mesangial cells here in blue which you can think
of as contractile cells that help regulate the blood flow in the area and in some condition in some nephrotic
conditions these cells are affected.

Parietal cells- special cells, are essentially squamous epithelial cells which forms the Bowman's capsule,
houses the glomerulus

Fenestrated epithelium- makes up the blood vessels; allow for filtration; contains blood and other blood stuff

Podocytes- surrounds basement membrane, in a way they help with the filtering process they help by
maintaining the integrity and structure of the glomerulus

GBM- surrounds fenestrated endothelium

normally you have the fenestrated endothelium here above it again is the glomerular basement membrane
then you have the podocytes and the surrounding Bowman's capsule

red blood cells and other proteins around this area cannot get filtered red blood cells cannot get filtered
because they are they are way too big for the capillaries the fenestrated endothelium the proteins cannot get
filtered because one they are still too big and two the podocytes prevent protein from passing through the

podocytes does this because it has negatively charged surface which repels the negatively charged protein
ions

in nephrotic syndrome there is essentially injury to the podocytes due to many reasons mainly either from
immune complex deposition or complement protein activation which leads to subsequent damage the proteins
that are not usually able to pass through this these layers can now pass through with towards the Bowman's
capsule and into
the tubulin leading to proteinuria sometimes blood can even get through if the damaged if the damaged area
also includes the glomerular basement membrane and the capillaries so that was an overview of what
happens in nephrotic syndrome you have immune complex and complement proteins leading to damage to the
podocytes which normally would prevent protein from getting through