Progression of chronic renal disease.
Risk factors for progression of kidney disease include hypertension, proteinuria, male sex, obesity, diabetes mellitus, hyperlipidemia, smoking, high-protein diets, phosphate retention, and metabolic acidosis. Angiotensin II production upregulates the expression of transforming growth factor-beta1, tumor necrosis factor-alpha, nuclear factor-kappaB, and several adhesion molecules and chemoattractants. In addition to angiotensin, other vasoactive compounds, such as thromboxane A(2), endothelin, and prostaglandins, are upregulated. Treatment with one of several growth factors may ameliorate the progression of kidney disease: insulin-like growth factor-1, hepatocyte growth factor, and bone morphogenetic protein-7.
Klahr
Saulo
S
Department of Internal Medicine, Washington University School of Medicine at Barnes-Jewish Hospital (North Campus), St Louis, MO 63110-1092, USA. sklahr@im.wustl.edu
Morrissey
Jeremiah
J
D000804:Angiotensin II / Q000502:physiology; D000818:Animals; D018450:Disease Progression; D006133:Growth Substances / Q000627:therapeutic use; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000473:pathology*; D016328:NF-kappa B / Q000502:physiology; D016212:Transforming Growth Factor beta / Q000502:physiology; D053773:Transforming Growth Factor beta1; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology
D006133:Growth Substances; D016328:NF-kappa B; C508960:TGFB1 protein, human; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1; D014409:Tumor Necrosis Factor-alpha; D000804:Angiotensin II