Progression of renal scarring: a balancing act

The progression of renal scarring and fibrosis is a complex process involving intricate interactions between a wide range of pro-scarring and anti-scarring forces and mediators. A better understanding of these events should allow more rational interventions based on their manipulations. Unfortunately, while rapid and considerable progress has been made in experimental animals and in the rat in particular, these so far have had a limited impact on progressive nephropathies in humans. It is as if clinical interventions continue to proceed along different lines, defined decades ago.