Potential approaches to reverse or repair renal fibrosis

Nat Rev Nephrol. 2014 Apr;10(4):226-37. doi: 10.1038/nrneph.2014.14. Epub 2014 Feb 11.


The concept of reversing chronic kidney disease (CKD) has been intensively researched over the past decade. Indeed, as the prevalence of end-stage renal disease is constantly on the rise, the lack of established antifibrotic therapies is a considerable unmet need in clinical practice. Now, the possibility of effective antifibrotic treatment has been established in experimental models of CKD and multiple antifibrotic compounds-in kidney disease, as well as in fibrotic diseases of the skin, liver and lung-are being assessed in clinical trials. These strategies target various components of the fibrotic pathway, from signalling molecules that include transforming growth factor-β, phosphatidylinositide 3-kinase and chemokines to microRNAs. Here, we discuss therapeutic concepts to inhibit or even reverse chronic kidney injury and review the leading candidate antifibrotic drugs to be introduced to clinical use.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Bone Morphogenetic Protein 7 / agonists
  • Connective Tissue Growth Factor / antagonists & inhibitors
  • Disease Progression
  • Endothelin-1 / antagonists & inhibitors
  • Epigenesis, Genetic / drug effects
  • Extracellular Matrix / metabolism
  • Fibroblasts / drug effects
  • Fibrosis
  • Humans
  • Kidney / drug effects
  • Kidney / pathology*
  • Kidney Diseases / drug therapy*
  • Kidney Diseases / pathology
  • Kidney Failure, Chronic / drug therapy*
  • Microcirculation / drug effects
  • Phosphodiesterase Inhibitors / therapeutic use
  • Pyridones / therapeutic use
  • Transforming Growth Factor beta / antagonists & inhibitors
  • Transforming Growth Factor beta / immunology


  • Anti-Inflammatory Agents
  • BMP7 protein, human
  • Bone Morphogenetic Protein 7
  • CCN2 protein, human
  • Endothelin-1
  • Phosphodiesterase Inhibitors
  • Pyridones
  • Transforming Growth Factor beta
  • Connective Tissue Growth Factor
  • pirfenidone