Mechanisms of progression of chronic kidney disease.
Chronic kidney disease (CKD) occurs in all age groups, including children. Regardless of the underlying cause, CKD is characterized by progressive scarring that ultimately affects all structures of the kidney. The relentless progression of CKD is postulated to result from a self-perpetuating vicious cycle of fibrosis activated after initial injury. We will review possible mechanisms of progressive renal damage, including systemic and glomerular hypertension, various cytokines and growth factors, with special emphasis on the renin-angiotensin-aldosterone system (RAAS), podocyte loss, dyslipidemia and proteinuria. We will also discuss possible specific mechanisms of tubulointerstitial fibrosis that are not dependent on glomerulosclerosis, and possible underlying predispositions for CKD, such as genetic factors and low nephron number.
Fogo
Agnes B
AB
Department of Pathology, Vanderbilt University Medical Center, MCN C3310, Nashville, TN 37232, USA. agnes.fogo@vanderbilt.edu
D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D018450:Disease Progression; D050171:Dyslipidemias; D005260:Female; D005355:Fibrosis / Q000473:pathology / Q000503:physiopathology; D020022:Genetic Predisposition to Disease; D006801:Humans; D006977:Hypertension, Renal / Q000503:physiopathology; D007674:Kidney Diseases / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*; D008297:Male; D050199:Podocytes / Q000378:metabolism / Q000473:pathology; D011110:Polymorphism, Genetic; D011507:Proteinuria; D012084:Renin-Angiotensin System / Q000502:physiology; D016212:Transforming Growth Factor beta / Q000235:genetics / Q000378:metabolism
D016212:Transforming Growth Factor beta