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Pathogenesis of proteinuria in idiopathic minimal change disease: molecular mechanisms

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Abstract

Minimal change disease (MCD) is the most common type of nephrotic syndrome in children and adolescents. The pathogenesis of proteinuria in this condition is currently being reassessed. Following the Shalhoub hypothesis, most efforts have been placed on identifying the putative circulating factor, but recent advancement in podocyte biology has focused attention on the molecular changes at the glomerular capillary wall, which could explain the mechanism of proteinuria in MCD. This report critically reviews current knowledge on the different postulated mechanisms at the glomerular capillary wall level for increased permeability to plasma proteins in MCD. The report helps describe the rationale behind novel therapies and suggests future targeted therapies for MCD.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, University of Florida, 1600 SW Archer Road, HD214, Gainesville, FL, 32607, USA

    Gabriel Cara-Fuentes & Eduardo H. Garin

  2. Department of Pathology, University of Florida, Gainesville, FL, USA

    William L. Clapp

  3. Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado, Denver, CO, USA

    Richard J. Johnson

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  1. Gabriel Cara-Fuentes
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Cara-Fuentes, G., Clapp, W.L., Johnson, R.J. et al. Pathogenesis of proteinuria in idiopathic minimal change disease: molecular mechanisms. Pediatr Nephrol 31, 2179–2189 (2016). https://doi.org/10.1007/s00467-016-3379-4

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