Pamela Morales; Daniel R. González & Jessica Zúñiga-Hernández

Diabetes mellitus (DM) is a disease of high global concern due to its sustained increase in prevalence and mortality. One of its most significant complications is diabetic nephropathy (DN), which affects approximately 40 % of patients with DM and is the leading cause of end-stage renal disease (ESRD), requiring dialysis and kidney transplant. The etiopathogenesis of DN is complex and multifactorial, however, the hyperglycemic environment produces a persistent inflammatory state, hypertension and generalized oxidative stress, with overproduction of reactive oxygen species (ROS), key processes in the development of this pathology. In DN, alterations in the morphology of the glomerular filtration barrier (GFB) are observed. The GFB is made up of the endothelium of the fenestrated capillaries, the glomerular basement membrane (GBM), and podocytes. Each of these relevant structures undergoes substantial changes in DN, ultimately leading to kidney failure producing proteinuria, which is a reference biomarker for detecting kidney damage. The objective of this review is to analyze these morphological changes in detail and how they are related to the development and progression of DN, including the signaling pathways and cellular events involved.

KEY WORDS: Morphology; Glomerular basement membrane; Endothelium; Podocytes; Diabetic nephropathy.

MORALES, P.; GONZÁLEZ, D. R. & ZÚÑIGA-HERNÁNDEZ, J. Morphological alterations of the glomerular filtration barrier relevant to the development and progression of diabetic nephropathy. Int. J. Morphol., 44(2):373-379, 2026.