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The global epidemic of chronic kidney disease (CKD) is progressing at an alarming rate. Ranging from mild to a most severe state, already up to 11% of the general population is affected in the US, Australia, Japan and Europe [1,2]. With a simultaneous steady increase of type II diabetes and its associated kidney complications, particularly in India, China and South-East Asia, kidney-related diseases globally are rapidly escaping any present treatment options and resources. In most cases of CKD, the first clinical sign is proteinuria. Thus, a better understanding of mechanisms controlling the kidney permeability barrier in health and disease is essential to design better early diagnostics and therapies, to act while permanent damage may still be preventable. The key to success should be in bringing the latest genetic and molecular findings efficiently into translational platforms and finally into clinical verification. The meticulously collected large patient databases should be an essential part of this process.

The nephrin-based slit diaphragm: new insight into the signalling platform identifies targets for therapy