New Insights into the Molecular Mechanisms of Podocytes Injury in Diabetes

Abstract

Pandemia of diabetes mellitus (DM) remains one of the biggest worldwide medical problems associated with dangerous complications, particularly diabetic nephropathy (DN), which is the leading cause of the end-stage renal disease. It was confirmed convincingly today that podocytes injury is implicated primarily or secondarily in various proteinuric glomerular diseases, including DN. The characteristic signs of podocytopathy are podocytes hypertrophy, foot process effacement, detachment from the glomerular basal membrane and apoptosis. Structural and functional alterations of podocytes evolve early, outpacing clinically significant albuminuria. The increasing loss of podocytes is associated with morphological and clinical signs of DN progression. This review details the molecular and cellular events, mediators and signaling pathways that contribute to podocytes injury in DM, discusses the most important achievements, clinical and experimental data in these issues, describes the urinary biomarkers of podocytes injury.