Growth factors: role in the progression of renal lesions

From pathophysiology to therapeutics: Nephrologists are faced with the cont inuing problem of helping patients avoid the onset or retard the developmen t of endstage renal failure, Despite the treatments available, the risk is still high for patients and the cost a heavy burden for the public health b udget. These facts underline the importance of a detailed understanding of the mechanisms leading to the destruction of renal parenchyma in order to d evelop therapeutic strategies capable of slowing the inevitable progression of kidney lesions. Growth factors: It is currently recognized that a major reduction in the nu mber of functional nephrons, whatever the initial cause, leads in itself to a progressive deterioration of healthy nephrons and finally to complete de struction of the kidney. The underlying mechanisms remain largely unknown. One possible mechanism would involve an overexpression of several growth fa ctors in the damaged renal parenchyma, We present in this review experiment al data obtained with various approaches, including phramacological and/or dietetic modulations and the establishment of transgenic mouse lines, to de monstrate the key role played by growth factors in the progression of renal lesions. The pathways followed by these growth factors in the process of r enal destruction as well as certain elements leading to their overexpressio n are also discussed.