Q J Med 1999; 92: 421-424
© 1999 Association of Physicians
Editorial |
The progression of chronic renal failure: a harmful quartet
Sheffield Kidney Institute, Northern General Hospital
Renal Unit, Kent and Canterbury Hospital
The progression of chronic renal failure (CRF) remains one of the main challenges in clinical nephrology. Over the last quarter of a century, animal experimentation has identified many of the pathophysiological mechanisms underlying the associated renal scarring process. Consequently, research has implicated a wide range of mediators, including prominent roles for cytokines, chemokines and growth factors.1 This has suggested therapies based on the manipulation of these mediators and aimed at the prevention of progressive renal fibrosis and functional decline.1 Unfortunately, the relevance of these interventions and their applicability to patients with progressive renal insufficiency remain uncertain. Meanwhile, nephrologists continue to be faced with an increasing number of patients with progressive CRF. It is therefore imperative to review available clinical interventions based on the manipulation of known clinical risk factors for the progression of CRF.
Hypertension has been linked to the progression of chronic renal failure (CRF) since the pioneering days
References