Progress and Controversies in Unraveling the Glomerular Filtration Mechanism

Curr Opin Nephrol Hypertens. 2015 May;24(3):208-16. doi: 10.1097/MNH.0000000000000116.

Abstract

Purpose of review: At first sight, the glomerular filter appears like a problem that should be easily solved. The majority of researchers view the filter like an impermeable wall perforated by specialized and size-selective pores (pore model). However, the fact that this model is in conflict with many of the experimental findings suggests that it may not yet be complete.

Recent findings: In the more recent electrokinetic model, we have proposed including electrical effects (streaming potentials). The present review investigates how this can provide a relatively simple mechanistic explanation for the great majority of the so far unexplained characteristics of the filter, for example why the filter never clogs.

Summary: Understanding how the glomerular filter functions is a prerequisite to investigate the pathogenesis of proteinuric glomerular diseases and the link between glomerular proteinuria and cardiovascular disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Endothelium / metabolism
  • Glomerular Filtration Barrier / physiology*
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Kidney Diseases / pathology
  • Kidney Diseases / physiopathology*
  • Kidney Glomerulus / pathology
  • Kidney Glomerulus / physiology*
  • Proteinuria / metabolism*