THE ORIGIN AND NATURE OF ANISOTROPIC URINARY LIPIDS IN THE NEPROTIC SYNDROME

Abstract

The anisotropic lipid material in urine from patients with the nephrotic syndrome, in the form of "Maltese cross" spherulites, is apparently composed largely of cholesterol ester with a smaller component of free cholesterol. The labeled cholesterol ester in the urine sediment appeared more slowly than did the labeled cholesterol ester in solution (probably as lipoprotein). These findings suggest that the cholesterol esters, and possibly other lipids, are lost through the damaged glomerulus, are partly reabsorbed by the tubular cells, and are then re-extruded in a particulate form. Thus 2 distinct lipid phases appear in the urine[long dash]one a lipoprotein form in solution from the glomerular filtrate, and one a particulate form in the sediment arising from tubular cells.