Podocytopathies

The podocyte is a critical component of the glomerular filtration barrier. Injury to these specialized cells results in podocytopathies. A kidney biopsy will reveal focal segmental glomerulosclerosis or minimal change disease. These diseases can have variable clinical presentations and biopsy features, which will help classify them into primary or secondary podocytopathies and further guide treatment. Contrary to secondary focal segmental glomerulosclerosis, primary focal segmental glomerulosclerosis and minimal change disease require immunosuppression since spontaneous remission is rare and complications related to nephrotic syndrome can be life-threatening. Podocytopathies secondary to genetic mutations rarely require immunosuppression, but this may be indicated in special populations. The purpose of this review is to discuss key points in diagnosis and treatment for patients with podocytopathies.