Albuminuria acts as a marker of progressive chronic kidney disease and as an indicator for initiation of hypertension treatment via modulation of the renin-angiotensin-aldosterone system with angiotensin receptor blockers or angiotensin-converting enzyme inhibitors. However, the true significance of albuminuria has yet to be fully defined. Is it merely a marker of underlying pathophysiology, or does it play a causal role in the progression of kidney disease? The answer remains under debate. In this issue of the JCI, Bedin et al. used next-generation sequencing data to identify patients with chronic proteinuria who had biallelic variants in the cubilin gene (CUBN). Through investigation of these pathogenic mutations in CUBN, the authors have further illuminated the clinical implications of albuminuria.

蛋白尿可作为进行性慢性肾脏疾病的标志物，并可作为通过用血管紧张素受体阻滞剂或血管紧张素转化酶抑制剂调节肾素-血管紧张素-醛固酮系统开始高血压治疗的指标。但是，蛋白尿的真正意义尚未完全确定。它仅仅是基础病理生理的标志物，还是在肾脏疾病的进展中起因果作用？答案仍在辩论中。在JCI的这一期中，Bedin等人。使用下一代测序数据来鉴定具有cubilin基因（CUBN）中双等位基因变异的慢性蛋白尿患者。通过研究CUBN中的这些致病突变，作者进一步阐明了蛋白尿的临床意义。