A clinical case of metabolic nephropathy with severe proteinuria

Globally, the prevalence of chronic kidney disease (CKD) is approaching epidemic levels. Some CKD phenotypes of secondary etiology are characterized by slow progression with a prolonged period of asymptomatic progression, does not reach nephrotic levels. Assessing prognostic markers in the early stages of CKD is essential to reduce the risk of progression to kidney dysfunction and cardiovascular disease through timely pathogenetic correction. This should be addressed not only by nephrologists but also by other primary care practitioners. This article describes a 64-year-old male patient with obesity, episodes of hyperglycemia, and long-standing arterial hypertension. Biochemical analysis confirms hyperglycemia, hyperuricemia, and dyslipidemia. Morphological studies indicate the development of secondary segmental glomerulosclerosis, including in the vascular pole of the glomeruli. Autoimmune pathology has been excluded. Urinalysis revealed episodes of proteinuria up to 4.2 g per day. After adequate treatment of hypertension, dyslipidemia, hyperglycemia, and hyperuricemia, a decrease in proteinuria was observed. The evaluation and treatment of these patients requires a comprehensive approach, with the mandatory participation of nephrologists and endocrinologists.when proteinuria