Nephrol Dial Transplant (2002) 17: 951-955
© 2002 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
Novel concepts in understanding and management of glomerular proteinuria
Department of Medicine, and Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, New York 10461, USA
Keywords: angiotensin converting enzyme; angiotensin receptor blocker; glomerular permselectivity; lipid rafts; podocytes; proteinuria
‘Form follows function’ and ‘time is precious’: these principles are conflated in the glomerular podocyte. They define its function but also the necessity to limit the exposure of podocytes to injurious agents. A number of glomerular disorders that may lead to chronic kidney disease are characterized by simplification and retraction of podocyte foot processes (FP) (effacement). These structural podocyte defects are highly reversible for a certain time and every effort should be undertaken to prevent disease progression and the need for renal replacement therapy, which harbors enormous financial and human costs. Podocytes elaborate a network of processes—major processes and FP, which surround glomerular capillaries. Together with the glomerular basement membrane (GBM) and the glomerular endothelial cells, podocytes provide the structural basis for glomerular filtration [1]. Although it is generally acknowledged that the GBM can restrict the passage of large plasma proteins, there is increasing evidence that the ultimate
The slit diaphragm: a dynamic site of glomerular permselectivity
Involvement of lipid rafts in functional organization of the SD
The response of podocytes to injury
Treatment of proteinuria and progression of renal disease by molecular modulation of podocyte function
Outlook
Acknowledgments
Notes
References
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