[HTML][HTML] Mechanisms of progression and regression of renal lesions of chronic nephropathies and diabetes

G Remuzzi, A Benigni, A Remuzzi - The Journal of clinical …, 2006 - Am Soc Clin Investig
The Journal of clinical investigation, 2006Am Soc Clin Investig
The incidence of chronic kidney diseases is increasing worldwide, and these conditions are
emerging as a major public health problem. While genetic factors contribute to susceptibility
and progression of renal disease, proteinuria has been claimed as an independent predictor
of outcome. Reduction of urinary protein levels by various medications and a low-protein
diet limits renal function decline in individuals with nondiabetic and diabetic nephropathies
to the point that remission of the disease and regression of renal lesions have been …
The incidence of chronic kidney diseases is increasing worldwide, and these conditions are emerging as a major public health problem. While genetic factors contribute to susceptibility and progression of renal disease, proteinuria has been claimed as an independent predictor of outcome. Reduction of urinary protein levels by various medications and a low-protein diet limits renal function decline in individuals with nondiabetic and diabetic nephropathies to the point that remission of the disease and regression of renal lesions have been observed in experimental animals and even in humans. In animal models, regression of glomerular structural changes is associated with remodeling of the glomerular architecture. Instrumental to this discovery were 3D reconstruction studies of the glomerular capillary tuft, which allowed the quantification of sclerosis volume reduction and capillary regeneration upon treatment. Regeneration of capillary segments might result from the contribution of resident cells, but progenitor cells of renal or extrarenal origin may also have a role. This review describes recent advances in our understanding of the mechanisms and mediators underlying renal tissue repair ultimately responsible for regression of renal injury.
The Journal of Clinical Investigation