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The role of infiltrating leukocytes in progressive renal disease: implications for therapy

Nature Clinical Practice Nephrology volume 2, pages 348–349 (2006)Cite this article

The search for better and more cost-effective management strategies for chronic kidney disease (CKD) provides nephrologists with one of their greatest challenges, because this disease has become an epidemic in both the developed and the developing worlds. Two different strategies are being used to meet this challenge. Firstly, there are pragmatic approaches that seek to optimize management of known risk factors such as hypertension and other cardiovascular influences, and to assess the benefits of established drugs such as angiotensin-converting-enzyme (ACE) inhibitors and statins. Secondly, studies are being conducted to analyze the mechanisms responsible for progressive injury in order to identify novel therapeutic targets. These approaches have often been considered entirely separate—even opposing—but recent studies are beginning to force a revision of this misconception.

Progressive renal fibrosis is characteristic of all the diseases that cause renal failure. It is mediated by activated renal fibroblasts and myofibroblasts, which arise through migration of blood-borne precursor cells, local proliferation and epithelial-to-mesenchymal transition. These processes are invariably associated with a prominent leukocyte infiltrate consisting of macrophages and T cells, together with apoptosis of tubular epithelial cells and destruction of the peritubular capillaries.1 The extent to which the processes responsible for progressive renal fibrosis are controlled by these infiltrating leukocytes is unclear.

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  1. Regius Professor of Medicine at the University of Aberdeen, UK

    Andrew J Rees

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  1. Andrew J Rees
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Correspondence to Andrew J Rees.

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Rees, A. The role of infiltrating leukocytes in progressive renal disease: implications for therapy. Nat Rev Nephrol 2, 348–349 (2006). https://doi.org/10.1038/ncpneph0216

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