Resolution of renal disease: mission impossible?

Several studies have extensively shown that both dietary and pharmacologica l intervention can prevent the progression of renal damage. The best result s may be obtained by optimizing blood pressure control, reducing proteinuri a levels in non diabetic nephropathies, and further achieving a good glycem ic control in diabetic nephropathies. The earlier the treatment is started, the better the results. Since slowing progression of renal disease has been established, the challe nge of the future seems to be the resolution of an established renal damage . Few studies have suggested that this process of regression is possible, E xperimental animal studies, based on repeated renal morphological investiga tions, showed resolution of glomerular lesions in 40% of animals treated wi th either ACEI or AIIRA. Resolution of renal lesions (62%) has been claimed in a single study and in a small number of patients with diabetic nephropa thy after 10-year pancreas transplantation. Confirmation studies are awaite d.