Mechanisms in remodeling of the kidney

Masaomi Nangaku, Toshio Miyata

Research output: Contribution to journalReview articlepeer-review


Representative remodeling of the kidney in CKD includes development of glomerulosclerosis and tubulointerstitial fibrosis. Injury to glomerular endothelium, mesangium, or podocyte can induce glomerulosclerosis, although recent studies have focused on a role of podocytes due to its lack of proliferation. Development of tubulointerstitial fibrosis is multi-factorial, and includes proteinuria, chronic hypoxia, activation of the intra-renal renin-angiotensin system, imbalance of matrix production and protease activity, and epithelial-mesenchymal transdifferentiation. Optimal remodeling may induce restoration of normal kidney structure, and some potential candidates of resident renal stem cells have been proposed. Development of therapeutic approaches targeting final common pathways will open a new avenue in management of patients with CKD.

Original languageEnglish
Pages (from-to)1696-1700
Number of pages5
JournalNippon rinsho. Japanese journal of clinical medicine
Issue number9
Publication statusPublished - 2008


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