Abstract

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 withdDMisthean leading cause of end-stage renal disease (ESRD), requiring dialysis and kidney transplant. The etiopathogenesis of DN is andxcomple multifactorial, however, the hyperglycemic environment produces a persistent inflammatory state, hypertension and generalizedxidative o stress, with overproduction of reactive oxygen species (ROS), key processes in the development of this pathology. In DN,alterationsin 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 substantialngescha in DN, ultimately leading to kidney failure producing proteinuria, which is a reference biomarker for detecting kidney Thedamage. objective of this review is to analyze these morphological changes in detail and how they are related to the developmentand progression of DN, including the signaling pathways and cellular events involved.