Mechanisms of progression and regression of renal lesions of chronic nephropathies and diabetes
J. Clin. Invest. Giuseppe Remuzzi, et al. 116:288 doi:10.1172/JCI27699 [
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Figure 1The progressive nature of chronic kidney disease. The progression to ESRD, as underlined by the progressive decline of GFR, is highly variable. Here is reported the natural history of autosomal-dominant polycystic kidney disease (ADPKD) in patients with PKD1 mutation in the
PKD1 gene as an example of genetic renal disease. Progressive renal disease occurs in 20–40% of patients with type 2 diabetes. Progression to renal failure occurs in 30% of patients with IgA nephropathy after a follow-up of 25 years. Similarly, 30% of patients with membranous nephropathy reach ESRD within the 30-year follow-up period. A more rapid course is observed for patients with mesangial capillary glomerulonephritis or primary focal and segmental glomerulosclerosis, who possess persistently high urinary protein excretion rates.
