Remnant nephron physiology and the progression of chronic kidney disease

In chronic kidney disease, ongoing failure of individual nephrons leads to the progressive loss of renal function. This process results in part from a cellular and molecular response to injury that represents an attempt to maintain homeostasis but instead initiates a program that damages the nephron...

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Published inPediatric nephrology (Berlin, West) Vol. 29; no. 2; pp. 193 - 202
Main Author Schnaper, H. William
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2014
Springer
Springer Nature B.V
Subjects
Analysis
Chronic kidney failure
Creatinine
Development and progression
Disease Progression
Educational Review
Fibroblasts
Growth factors
Hemodialysis
Homeostasis
Humans
Kidney diseases
Kidney tubules
Medicine
Medicine & Public Health
Nephrology
Nephrons - pathology
Nephrons - physiopathology
Pediatrics
Physiological aspects
Physiology
Reactive oxygen species
Renal Insufficiency, Chronic - pathology
Renal Insufficiency, Chronic - physiopathology
Sodium
Uremia
Urology
United States > US
Chicago Illinois
Nephron
Reactive oxygen species
Chronic kidney disease
Fibrosis
Hypertrophy
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Summary:In chronic kidney disease, ongoing failure of individual nephrons leads to the progressive loss of renal function. This process results in part from a cellular and molecular response to injury that represents an attempt to maintain homeostasis but instead initiates a program that damages the nephron. As nephrons are lost, compensation by the remaining nephrons exacerbates glomerular pathophysiology. The delivery of excessive amounts of biologically active molecules to the distal nephron and tubulointerstitium generates inflammation and cellular dedifferentiation. Energy requirements of hyperfunctioning nephrons exceed the metabolic substrate available to the renal tubule, and inadequacy of the local vascular supply promotes hypoxia/ischemia and consequent acidosis and reactive oxygen species generation. In this way, mechanisms activated to maintain biological balance ultimately lead to demise of the nephron.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-013-2494-8