The critical role of tubulointerstitium in renal disease progression

Abstract

Background: Recent works have demonstrated that, regardless of the primary causes, tubulointerstitial (TI) fibrosis is the major cause of progression of renal failure. Objective: To summarize the mechanisms of progression and regression of TI damage. Results: Experimental studies have shown that there are three common processes of progressive TI damage: injury, inflammation, and fibrosis. Renin angiotensin system (RAS) blocking agents could substantially decrease these lesions. Conclusion: The fulcrum of the balance between progression and regression of TI fibrosis remains to be elucidated but would be related to the activation of RAS.