Integrating Traditional Chinese Medicine in the Management of Podocytopathies

Podocytopathy, the most common feature of glomerular disease, is characterized by excessive proteinuria resulting from direct or indirect podocyte injury or dysfunction, ultimately leading to glomerulosclerosis and permanent loss of kidney function. The following four diseases are classified as podocytopathies: diffuse mesangial sclerosis, minimal change disease, focal segmental glomerulosclerosis, and collapsing glomerulopathy. The lesion patterns associated with these conditions have long been considered independent of specific diseases. However, recent experimental studies have revealed that these lesions indicate repeated damage and repair attempts, influenced by the type, duration, and severity of podocyte injury, as well as the capacity of renal cells to facilitate repair. In this article, we discuss the histopathological changes associated with podocytopathies to provide a clinical basis for their diagnosis. In addition, we explore the potential of traditional Chinese medicines (TCMs) in treating podocytopathies, focusing on the use of Chinese herbal medicines to modulate immune responses, reduce proteinuria, and slow disease progression, thus offering a complementary therapeutic strategy to conventional treatments.