The role of tubulointerstitial injury in chronic renal failure

Progressive renal failure results from a triad of glomerulosclerosis, tubul ointerstitial fibrosis and vascular sclerosis. The mechanisms by which tubu les are injured, and by which the tubular epithelial cell then excites inte rstitial inflammation culminating in fibroblast activation and fibrosis hav e become increasingly understood. Most current methods to prevent progressi ve glomerulosclerosis would inherently prevent tubular injury and interstit ial fibrosis. The behaviour and control of the renal fibroblast is being in vestigated, with the potential for direct interference with its functions. Curr Opin Nephrol Hypertens 9:133-138. (C) 2000 Lippincott Williams & Wilki ns.