Progression versus regression of chronic kidney disease.

Summary In summary, current experimental and human datasupport that there is a possibility for regression ofexisting glomerulosclerosis that involves alterations ofboth ECM and glomerular parenchymal cells in acomplex coordinated manner. Angiotensin seems to bea key mediator of many of these processes, affectingblood pressure, matrix and podocyte interaction withcapillaries. The challenge remains to identify patientsat early enough stages where regression could beachieved, and to optimize interventions to target themany processes driving sclerosis, thus unleashing theglomerular potential for remodelling. Conﬂict of interest statement. None declared. References 1. Fogo A. Progression and potential regression of glomerulo-sclerosis. Nephrology Forum. Kidney Int 2001; 59: 804–8192. Ikoma M, Kawamura T, Kakinuma Y, Fogo A, Ichikawa I.Cause of variable therapeutic efﬁciency of angiotensin convert-ing enzyme inhibitor on glomerular lesions. Kidney Int 1991; 40:195–2023. 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