Progression of chronic renal disease

Am J Kidney Dis. 2003 Mar;41(3 Suppl 1):S3-7. doi: 10.1053/ajkd.2003.50074.


Risk factors for progression of kidney disease include hypertension, proteinuria, male sex, obesity, diabetes mellitus, hyperlipidemia, smoking, high-protein diets, phosphate retention, and metabolic acidosis. Angiotensin II production upregulates the expression of transforming growth factor-beta1, tumor necrosis factor-alpha, nuclear factor-kappaB, and several adhesion molecules and chemoattractants. In addition to angiotensin, other vasoactive compounds, such as thromboxane A(2), endothelin, and prostaglandins, are upregulated. Treatment with one of several growth factors may ameliorate the progression of kidney disease: insulin-like growth factor-1, hepatocyte growth factor, and bone morphogenetic protein-7.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Angiotensin II / physiology
  • Animals
  • Disease Progression
  • Growth Substances / therapeutic use
  • Humans
  • Kidney Failure, Chronic / drug therapy
  • Kidney Failure, Chronic / pathology*
  • NF-kappa B / physiology
  • Transforming Growth Factor beta / physiology
  • Transforming Growth Factor beta1
  • Tumor Necrosis Factor-alpha / physiology


  • Growth Substances
  • NF-kappa B
  • TGFB1 protein, human
  • Transforming Growth Factor beta
  • Transforming Growth Factor beta1
  • Tumor Necrosis Factor-alpha
  • Angiotensin II