EPISODE 7

From Podocyte to Patient: The Pathophysiology of FSGS

Tobias Huber, MD, Academic Nephrologist is the Chair of the Center of Internal Medicine at the University Medical Center Hamburg-Eppendorf, Germany and the President of the International Society of Glomerular Disease.

Chris Gisler is a Medical Director at Travere Therapeutics and a community nephrologist practicing in Pittsburgh.

In this episode, Drs. Tobias Huber and Chris Gisler take a deep dive into the critical role of podocytes in maintaining glomerular function and their central involvement in the development and progression of focal segmental glomerulosclerosis (FSGS). They examine the synergistic contributions of endothelin-1 and angiotensin II in exacerbating podocyte dysfunction and promoting disease progression. The discussion integrates current and emerging data on therapeutic strategies and biomarkers, including findings from Dr. Huber’s recent research. The episode concludes by emphasizing proteinuria as both a consequence and a driver of podocyte injury, reinforcing its importance as a mechanistic and therapeutic target in FSGS.

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Episode Summary

“I think we see very good evidence that the podocyte as a direct gatekeeper of retaining protein is the direct link to proteinuria.” (14:27)

“Not to harm patients is also a very important task for us as physicians. And in all honesty, I think there have been quite a few patients that we have been harming by giving them immunosuppressants while immunosuppressants were not targeting the underlying diseases.” (22:54)