Published online Sep 25, 2021. doi: 10.5527/wjn.v10.i5.88
Peer-review started: March 21, 2021
First decision: May 6, 2021
Revised: May 15, 2021
Accepted: August 10, 2021
Article in press: August 10, 2021
Published online: September 25, 2021
Processing time: 188 Days and 23.4 Hours
Core Tip: There is no doubt that some vascular hyperpermeability factor is involved in the incidence of proteinuria in idiopathic nephrotic syndrome (INS). However, no etiological molecule has been identified in INS as a factor for increasing the permeability of renal glomerular capillaries with reproducibility and clinical consistency. In addition, since the onset is sometimes observed in the family, there is high incidence of INS in East Asian children and there is the association of steroid-sensitive NS in childhood in Japan with the HLA-DR/DQ region, it is highly possible that some genetic factors are involved in the onset of NS. In our opinion, INS is a multifactorial disease in which immunological stimuli, trigger the production of substances that impair podocytes, resulting in dysfunction of the slit membrane and cause proteinuria.