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International Journal of Nephrology
Volume 2012, Article ID 749010, 9 pages
http://dx.doi.org/10.1155/2012/749010
Review Article

The Glomerular Filtration Barrier: Components and Crosstalk

1Division of Nephrology, Mount Sinai School of Medicine, New York, NY 10029, USA
2Division of Nephrology, James J. Peters VA Medical Center, Bronx, NY 10468, USA

Received 22 March 2012; Revised 2 June 2012; Accepted 5 June 2012

Academic Editor: Omran Bakoush

Copyright © 2012 Madhav C. Menon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The glomerular filtration barrier is a highly specialized blood filtration interface that displays a high conductance to small and midsized solutes in plasma but retains relative impermeability to macromolecules. Its integrity is maintained by physicochemical and signalling interplay among its three core constituents—the glomerular endothelial cell, the basement membrane and visceral epithelial cell (podocyte). Understanding the pathomechanisms of inherited and acquired human diseases as well as experimental injury models of this barrier have helped to unravel this interdependence. Key among the consequences of interference with the integrity of the glomerular filtration barrier is the appearance of significant amounts of proteins in the urine. Proteinuria correlates with kidney disease progression and cardiovascular mortality. With specific reference to proteinuria in human and animal disease phenotypes, the following review explores the roles of the endothelial cell, glomerular basement membrane, and the podocyte and attempts to highlight examples of essential crosstalk within this barrier.