Recent perspectives in the mechanisms and therapy of renal sclerosis

Chronic renal failure results from progressive sclerosis of injured kidney structures and overload of remnant functioning nephrons in an attempt to compensate for the lost excretory and fluid/solute regulatory capabilities. Key to delaying--or even reversing--the decay of renal function would be a therapy capable of blocking re-nal sclerosis. Therefore, a number of recent studies deal with this issue with a wealth of novel approaches. Considerable success has been achieved in experimental models by applying gene therapy, cell therapy, novel pharmacologic inhibitors of growth factors and matrigenic molecules. While the final step forward to human therapy is not an immediate option, it is likely that the next few years will witness initial trials of novel pharmacologic agents. Along with the already available new drugs suitable to prevent or delay renal transplant rejection or immunologic renal injury, the therapeutic scenario of contemporary nephrology is rapidly evolving. Some major novel findings in the area will be summarized, along with potential implications for human therapy.