Proteinuria in diabetic kidney disease: a mechanistic viewpoint

Kidney Int. 2008 Jul;74(1):22-36. doi: 10.1038/ki.2008.128. Epub 2008 Apr 16.


Proteinuria is the hallmark of diabetic kidney disease (DKD) and is an independent risk factor for both renal disease progression, and cardiovascular disease. Although the characteristic pathological changes in DKD include thickening of the glomerular basement membrane and mesangial expansion, these changes per se do not readily explain how patients develop proteinuria. Recent advances in podocyte and glomerular endothelial cell biology have shifted our focus to also include these cells of the glomerular filtration barrier in the development of proteinuria in DKD. This review describes the pathophysiological mechanisms at a cellular level which explain why patients with DKD develop proteinuria.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Diabetic Nephropathies / complications*
  • Diabetic Nephropathies / pathology
  • Endothelium, Vascular / pathology
  • Endothelium, Vascular / physiopathology
  • Glomerular Filtration Rate
  • Humans
  • Kidney Glomerulus / blood supply
  • Kidney Glomerulus / pathology
  • Kidney Glomerulus / physiopathology
  • Proteinuria / etiology*
  • Proteinuria / pathology