Hyperlipidemia of nephrosis: pathophysiologic role in progressive glomerular disease.

During the past few years, the increasing speculation that the hyperlipidemia of nephrosis may be one of several pathogenic mechanisms involved in the progression of initial glomerular injury to glomerulosclerosis has generated many clinical and experimental investigations. This discussion reviews pertinent studies that address two major issues. First, the underlying pathophysiologic mechanisms involved in the development of the hyperlipidemia of nephrosis are explored. Second, this article examines recent studies that investigate how this secondary hyperlipidemia may further aggravate initial glomerular injury and contribute to a progressive glomerulopathy, primarily mediated through alterations in monocyte/macrophage function.