Cellular and molecular mediators in common pathway mechanisms of chronic renal disease progression

Injury mechanisms activated by the hemodynamic adaptations to nephron loss are considered to represent a final common pathway that underlies the progr essive nature of chronic renal disease. In this article, we review experime ntal evidence that the induction of cell adhesion molecule, cytokine and pr ofibrotic growth factor gene expression and the resultant renal infiltratio n by inflammatory cells, especially macrophages, are important components o f these common pathway mechanisms. Interventions aimed at inhibiting these mechanisms may offer new treatments for slowing or arresting the progressio n of chronic renal disease. Curr Opin Nephrol Hypertens 9:323-331. (C) 2000 Lippincott Williams & Wilkins.