Progression, Remission, Regression of Chronic Renal Diseases

Lancet. 2001 May 19;357(9268):1601-8. doi: 10.1016/S0140-6736(00)04728-0.

Abstract

The prevalence of chronic renal disease is increasing worldwide. Most chronic nephropathies lack a specific treatment and progress relentlessly to end-stage renal disease. However, research in animals and people has helped our understanding of the mechanisms of this progression and has indicated possible preventive methods. The notion of renoprotection is developing into a combined approach to renal diseases, the main measures being pharmacological control of blood pressure and reduction of proteinuria. Lowering of blood lipids, smoking cessation, and tight glucose control for diabetes also form part of the multimodal protocol for management of renal patients. With available treatments, dialysis can be postponed for many patients with chronic nephropathies, but the real goal has to be less dialysis-in other words remission of disease and regression of structural damage to the kidney. Experimental and clinical data lend support to the notion that less dialysis (and maybe none for some patients) is at least possible.

Publication types

  • Review

MeSH terms

  • Animals
  • Chronic Disease
  • Disease Progression
  • Drug Therapy, Combination
  • Female
  • Humans
  • Kidney Diseases / epidemiology
  • Kidney Diseases / prevention & control
  • Kidney Diseases / therapy
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / prevention & control*
  • Kidney Failure, Chronic / therapy
  • Male
  • Primary Prevention / methods*
  • Prognosis
  • Recurrence
  • Remission Induction
  • Remission, Spontaneous
  • Renal Dialysis / methods
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Survival Rate