Podocytopathy in diabetes: A metabolic disorder

Background: Despite multifactorial interventions, the prevalence of diabetic kidney disease (DKD) is reaching epidemic proportions worldwide. Loss of podocytes, the cells forming the glomerular filtration barrier, occurs early in the development of DKD and is associated with the presence of albuminuria. Summary: Recent studies have implicated circulating hormones, adipokines and lipids in the development and progression of DKD. Key Message: Although the endocrine effects of these factors are widely recognized, less is known about their direct effects on podocytes and the resulting implications for DKD.