Pharmacological intervention in renal fibrosis and vascular sclerosis

Progressive renal disease is associated with the development of fibrosing l esions not only in the glomerulus, but also in the interstitial and vascula r compartments of the kidney. A growing body of work suggests that the mech anisms involved in this process are to a large extent shared by the glomeru lar mesangial cell, tubulointerstitial fibroblast and vascular smooth muscl e cell. In this review we consider evidence that treatment strategies focused on an y one of these cells are likely to be of universal benefit in the abrogatio n of the ongoing scarring that accompanies progressive renal disease, while at the same time reducing the progressive vascular sclerosis so often ulti mately responsible for the excessive mortality seen in patients with renal failure.