Mechanisms of Glomerular Albumin Filtration and Tubular Reabsorption

Figure 4

Possible mechanisms of albuminuria in minimal-change nephrotic syndrome. Albumin is filtered through the endothelial fenestrae, the basement membrane, and finally through the impaired slit diaphragm. Albumin is also filtered through the glomerular capillary wall where podocytes are lost by podocyte detachment or apoptosis causing enlarged slit pores and nonselective proteinuria. A mechanism of receptor-mediated albumin transport via FcRn through podocytes may explain the selective albuminuria in minimal-change disease.