[Renal sclerosis: a public health problem]

In France, 45,000 patients are treated by hemodialysis and/or transplantation for chronic renal failure. Every year 7,000 new patients need such a therapeutic approach. The estimated cost of this pathology is about 1% of the total amount of the budget of social security, even though the number of patients is limited. Some treatments were shown to be effective in improving the progression of chronic renal failure, as for example the anti-hypertensive therapy and the adequate treatment of diabetes mellitus. Collagen deposition in each segment of the kidney, mainly in the interstitium, plays a pivotal role in the progression of renal deficiency in chronic renal failure. In order to ameliorate the progression renal failure it would be essential to know: 1) the different types of collagen deposit; 2) the proteinase/antiproteinase systems involved in the remodelling of the extracellular matrix (serine-protease, metallo-protease and their inhibitors); 3) the autocrine/paracrine effects of proteases and of growth factors on collagen synthesis. The more precise the knowledge of these factors, the more useful will be new pharmacological-, gene- or cellular therapies for limiting the progression of chronic renal failure.