Abstract: Abstract: Objective　To study the relationship between angiopoietin-like 4 (Angptl4) and podocyte injury and protein uria in renal tissues of patients with primary nephrotic syndrome. Methods　Patients with primary nephrotic syndrome, including 11 cases of minimal change disease (MCD), 11 cases of membranous nephropathy (MN) and 9 cases of mesangial proliferative glomerulonephritis (MsPGN) were enrolled in this study. Renal tissues were collected during biopsy for Angptl4 and podocyte injury marker desmin immunofluorescence stainning, and fluorescence intensity was calculated. Angptl4 was double stained with podocyte marker synaptopodin, mesangial cell marker CD90, endothelial cell marker CD31 and glomerular basement membrane marker laminin to study the overlap rate of Angptl4 with various types of cells. The basic information of gender, age, 24 h-urine protein, serum triglycerides, serum total cholesterol and serum creatinine were collected. The correlation between the expression of Angptl4 and desmin immunofluorescence intensity, 24 h protein uria, serum triglycerides and serum total cholesterol was analyzed. Results　There were no significant differences in gender, age, serum creatinine and 24 h-urine protein between the three groups (P＞0.05). Compared with MsPGN patients, the glomerular Angptl4 expression increased in MCD and MN patients (P＜0.05), and the increased Angptl4 had the highest degree of overlap with podocytes rather than mesangial cells, endothelial cells or endothelial cells. Angptl4 expression in glomeruli was correlated with glomerular desmin expression and 24 h-urine protein (P＜0.01), but not correlated with the serum triglycerides and serum total cholesterol (P＞0.05). Conclusion　In patients with primary MCD and MN, the expression of glomerular Angptl4 is increased, which is associated with podocyte injury and proteinuria, but not with blood lipids.

Key words: angiogenic proteins, nephrotic syndrome, nephrosis, lipoid, glomerulonephritis, membranous, podocytes, proteinuria, angiopoietin-like 4