Approach to Studies on Podocyte Lesions Mediated by Hyperglycemia: A Systematic Review

Area of Science:

• Nephrology
• Diabetology
• Cell Biology

Background:

• Podocyte injury is central to diabetic nephropathy (DN) pathogenesis.
• Understanding the mechanisms driving podocyte dysfunction is crucial for developing effective treatments.

Purpose of the Study:

• To systematically review and synthesize the literature on podocyte injury in DN.
• To identify and consolidate the key mechanistic pathways involved in podocyte damage.

Main Methods:

• Systematic review of 7769 records across four databases, including 130 studies.
• Methodological quality assessed using Joanna Briggs Institute tools (mean score 81.3%).
• Temporal and geographical analysis of publication trends and study designs.

Main Results:

• Significant increase in research activity since 2018, with evolving multi-model study designs.
• Asia leading in contributions, with growing international collaborations.
• Five reproducible pillars of podocyte injury identified: adhesion failure, mTOR-autophagy-ER stress, oxidative injury, immune activation, and epigenetic reprogramming.

Conclusions:

• Podocyte injury in DN results from a convergent mechanistic cascade.
• Findings provide a framework for therapeutic interventions targeting barrier integrity, metabolic balance, and immune regulation.