From Glomerular Endothelium to Podocyte Pathobiology in Preeclampsia: a Paradigm Shift

Preeclampsia is a pregnancy-specific syndrome characterized by renal dysfunction and high blood pressure. When evaluated with light microscopy, the renal lesion of preeclampsia is marked by endothelial cell swelling and the appearance of bloodless glomeruli. However, regarding the pathobiology of renal damage in preeclampsia, attention recently has shifted from the glomerular endothelial cells to the podocytes. The angiogenic imbalance in preeclampsia plays a key role in the development of both podocyte and endothelial damage in the glomerular filtration barrier. Here, we review the latest studies on the role of podocytes in the development of renal damage in preeclampsia and on podocytes as potential targets for diagnosis, treatment, and prevention of long-term complications of preeclampsia.