Insulin signalling to the podocyte; pathological importance and therapeutic potential.

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The number of people in the world who are developing end stage kidney failure is rapidly increasing principally due to this condition being associated with diabetes. When this occurs patients require multiple medications, together with dialysis or kidney transplantation, or they die. Discovering new ways to prevent kidney failure is therefore critical. We have discovered that a cell, called the podocyte, in the kidney is implicated in the early stages of kidney disease (before the kidney completely fails) and this cell is responsive to a hormone called insulin. It appears that this cell needs insulin to remain healthy. We now want to understand exactly how insulin signals to the podocyte and explore if increasing insulin sensitivity of the this cell can prevent the kidney from completely failing. If this is true then strategies that increase podocyte insulin sensitivity could have great therapeutic potential in preventing kidney failure and stopping patients needing dialysis or kidney transplantation.