Fig. 4
Modeling of adaptive and maladaptive (pathological) effects of elevated glomerular hydrostatic pressure. When glomerular pressure is increased above normal, glomeruli adapt by growing, thereby increasing the filtering surface area and the associated ultrafiltration coefficient Kf in a relatively fast (over the course of weeks) saturating process. At the same time, elevated glomerular pressure initiates glomerulosclerosis, a much slower and non-saturating process that increases the basement membrane thickness, thus reducing permeability and lowering Kf. Elevated glomerular pressure also damages the podocytes, effectively increasing the protein sieving coefficient
