A clinically important characteristic of chronic renal disease, regardless of the underlying cause, is its frequently relentless progression to end-stage renal failure. Functional deterioration is often inevitable even after the initial pathological mechanism has apparently subsided. The possibility has therefore been raised for some time that, after a certain degree of renal damage by the initial disease processes, a common pathway leads to the final progressive functional and structural deterioration. Intensive clinical and experimental animal studies, both
in vivo and
in vitro, carried out during the last decade have identified several potentially important pathophysiologic mechanisms contributing to this progressive destruction of renal architecture. In this article we will review these recent findings and outline the current directions of research in this field.
View full abstract