The pathogenetical mechanism of glomerular proteinuria

Although the pathologic mechanisms responsible for glomerular proteinuria have not been completely clarified, yet, it has become evident that structural and functional abnormalities of podocytes play an early and important role. These data come from recent studies analyzing podocyte behaviour in cell culture, in-depth clinical researches, the application of survey techniques on isolated glomeruli, proteomic studies on particular aspects of circulating factors. For most glomerulopathies, whether primary or secondary, podocytes are often the first target for many pathogenetic mechanisms, which, unexpectedly, have the common characteristic of inducing tropism in podocytes. Hopefully, advances in glomerular podocyte research will better define clinical diseases, which we now classify according to a static description of the histological damage, thus perhaps mistaking causes and effects.