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Review
. 2011 Oct;58(4):666-77.
doi: 10.1053/j.ajkd.2011.05.032. Epub 2011 Aug 24.

Podocyte disorders: Core Curriculum 2011

J Ashley Jefferson  1 , Peter J Nelson, Behzad Najafian, Stuart J Shankland
Affiliations
Review

Podocyte disorders: Core Curriculum 2011

J Ashley Jefferson et al. Am J Kidney Dis. 2011 Oct.
No abstract available

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Figures

Figure 1
Figure 1. Glomerular capillary wall
The 3 layers of the capillary wall (glomerular endothelial cell, glomerular basement membrane (GBM), and podocyte) act as the glomerular filtration barrier (GFB) preventing proteins and large molecules from passing from the capillary lumen into the urinary space. The podocyte cell body lies with the urinary space, and the cell is attached to the GBM via the foot processes. Adjacent foot processes are separated by the filtration slit, bridged by the slit diaphragm. Disruption of the GFB leads the passage of protein across the capillary wall leading to proteinuria.
Figure 2
Figure 2. Renal Pathology of Clinical Podocyte Disorders
(A) Light microscopy image of a normal glomerulus, Jones methenamine silver (JMS) stain; (B) Electron micrograph of a capillary loop from a normal glomerulus. Arrow heads point to regularly arranged intact foot processes. cap = capillary lumen, GBM = glomerular basement membrane, p = podocyte, e = endothelial cell; (C) Extensive effacement of foot processes (arrowheads) in minimal change disease. Spiral arrows point to microvillus transformation of podocytes; (D) Focal segmental glomerulosclerosis (FSGS), not otherwise specified (NOS) with obliterated capillary loops (*), hyalin deposition and adhesion of tuft to Bowman's capsule, periodic acid Schiff (PAS) stain; (E) FSGS, perihilar variant with segmental sclerosis at the vascular pole (*), PAS; (F) FSGS, tip variant with segmental sclerosis (arrow) located at the glomerulotubular junction (*), JMS; (G) FSGS, cellular variant with foam cells (arrowhead) infiltrating capillary loops of sclerotic segment and prominent overlying podocytes (spiral arrow), but no collapse of capillary loops, JMS; (H) FSGS, collapsing variant with collapse of capillary loops and podocyte proliferation (*), JMS; (I) Membranous nephropathy with thickened glomerular basement membrane. The inset shows a magnified view of capillary loops with frequent GBM holes (arrow) and spikes (arrowhead); (J) Immunofluorescent staining for IgG in membranous nephropathy shows global fine granular peripheral capillary wall staining pattern; (K) Electron micrograph of membranous nephropathy with subepithelial immune complex deposits (arrowhead) and extensive effacement of foot processes; (L) Electron micrograph of a case of membranous nephropathy secondary to lupus erythematosus. Arrow heads show subepithelial deposits and arrow shows an endothelial tubuloreticular inclusion, a common finding in lupus nephritis.
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