Is kidney injury a reversible process?

PURPOSE OF REVIEW

Recent evidence indicates that the progression of renal fibrosis is a reversible process in experimental models. This review summarizes the new insights concerning the mechanisms of progression and regression of renal disease and examines this novel evidence in the light of feasibility and transfer to human nephropathies.

RECENT FINDINGS

Most of the studies investigated prevention rather than reversal of renal disease. Interesting results have been obtained using agents antagonizing the signaling pathway of transforming growth factor-beta, by blockers of the tyrosine kinase growth factor receptors and by kinin receptor activation.

SUMMARY

The future for therapy belongs to systems that mediate simultaneously proliferation, fibrosis and inflammation. Inhibitors of this kind of mediator will provide valuable assistance to 'classical' therapy with angiotensin II blockers, in order to achieve regression of renal fibrosis and reversal of renal failure.