The Role of Proximal Tubular Cells in the Early Stages of Diabetic Nephropathy
Giovani B Peres and Yara M Michelacci*
Department of Biochemistry, Paulista School of Medicine, Unifesp, São Paulo, SP, Brazil
- *Corresponding Author:
- Yara M Michelacci
Department of Biochemistry
Paulista School of Medicine
Unifesp, 100 04044-020 – São Paulo
Tel: 55-11- 5576-4438, extn 1187
E-mail: [email protected]
Received date: April 23, 2015; Accepted date: May 15, 2015; Published date: May 20, 2015
Citation: Peres GB, Michelacci YM (2015) The Role of Proximal Tubular Cells in the Early Stages of Diabetic Nephropathy. J Diabetes Metab 6:551. doi: 10.4172/2155-6156.1000551
Copyright: © 2015 Peres GB, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The present paper reviews the role of proximal tubular cells in the early stages of diabetic nephropathy. The chronic hyperglycemia that occurs in diabetes mellitus may have different effects on different cells, and some kidney cell types may be injured earlier than others. Recent findings point towards a relevant involvement of proximal tubular cells in the early stages of diabetic nephropathy. As normal urine contains very low amounts of proteins, while proteinuria occurs in kidney diseases, it was believed that the glomerular filtration barrier was capable of preventing the passage of proteins. Nevertheless, recent data indicate that the primary filtrate does contain albumin and other proteins, which possibly are reabsorbed by tubular cells. So, the increased albuminuria that occurs in diabetic nephropathy and other renal diseases could result, at least in their early stages, from defective tubular processing. The participation in this process of the receptors megalin, cubilin, and the newborn Fc receptor (FcRn) is discussed, regarding both protein transcytosis and lysosomal digestion. The processing and urinary excretions of sulfated polysaccharides are also briefly considered.