Mechanical Stress and Protective Mechanisms in Podocytes: Insights into Hypertensive Nephropathy

Mechanical stress on the glomerular filtration barrier (GFB) exposes podocytes to hydrostatic pressure. Their mechanosensitivity is established, yet the underlying mechanotransduction pathways and responses under hypertension remain unclear. This review examines the mechanical stresses experienced by podocytes in both physiologic and hypertensive conditions and updates the latest extracorporeal techniques used to simulate these forces. Additionally, this review discusses how podocytes respond to these mechanical forces and elucidates the detailed molecular mechanisms involved. Furthermore, we summarize potential protective mechanisms that enable podocytes to withstand mechanical challenges and propose novel therapeutic strategies to delay the progression of hypertensive nephropathy. This review uniquely underscores the importance of biomechanical factors in disease progression and integrates emerging therapeutic strategies targeting podocyte mechanotransduction, offering a novel biomechanical framework for delaying hypertensive nephropathy progression.