Journal
PEDIATRIC NEPHROLOGY
Volume 22, Issue 12, Pages 2011-2022Publisher
SPRINGER
DOI: 10.1007/s00467-007-0524-0
Keywords
angiotensin; angiotensin I converting enzyme inhibitors (ACEI); angiotensin receptors; angiotensin receptor blockers; transforming growth factor (TGF)-beta; glomerulosclerosis; interstitial fibrosis; podocytes; low birth weight
Categories
Funding
- NIDDK NIH HHS [DK 56942, P50 DK044757, R01 DK056942, DK 44757] Funding Source: Medline
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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.
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