Aims/hypothesis. Changes in podocyte number and morphology have been implicated in the pathogenesis of proteinuria and the progression of
human and experimental kidney disease. This study sought to examine podocyte foot process and slit pore architecture in experimental
diabetic nephropathy and to determine whether such changes were modified with renoprotective intervention by blockade of the
renin-angiotensin system.
Methods. The number of filtration slits per 100 μm of glomerular basement membrane was assessed by transmission electron microscopy
and quantitated histomorphometrically in control animals and in rats with 24 weeks of streptozotocin-induced diabetes. Diabetic
rats were either untreated or received the angiotensin converting enzyme inhibitor ramipril, or the angiotensin II type 1
receptor antagonist, valsartan.
Results. When compared with control animals, diabetes was associated with a decrease in the number of slit pores per unit length of
glomerular basement membrane, indicative of podocyte foot process broadening. Both ramipril and valsartan attenuated these
ultrastructural changes to a similar degree. These differences remained after correcting for glomerular volume as a possible
confounding variable.
Conclusion/interpretation. Preservation of podocyte architecture could contribute to the renoprotective effects of renin-angiotensin system blockade
in diabetic nephropathy. [Diabetologia (2001) 44: 878–882]
Keywords Podocyte - foot process - diabetic nephropathy - ramipril - valsartan.
Received: 19 January 2001 and in revised form: 28 March 2001