Renal Fibrosis Can Lead To Uremia

Renal fibrosis is a pathological damage process which leads to various continuous deterioration of chronic kidney disease(CKD). Its pathogenesis includes:

1. When various pathological injury lead to microcirculation disturbance of damaged kidneys, it causes ischemia and hypoxia of kidney tissues.

2. Because of ischemia and hypoxia, it will impair renal vascular endothelial cells.

3. Once the endothelia cells are injured, it will attract inflammatory cells of blood circulation, which releases the pathogenesis of inflammatory medium. In this condition, the process of renal fibrosis is activated. At this time, the pathogenesis injury will induce inflammatory reaction of damaged kidneys. Pathological changes of glomeruli will occur including mesangial cell proliferation and increased extracellular matrix(ECM). Glomerular basement membrane (GBM) will present some changes: such as filtering hole enlarged or shutting, GBM breakage, injury charge barrier and enlarged renal permeability. In the clinic, patients will have protein in urine and blood in urine. And then glomeruli will progress to renal fibrosis and hardening phase gradually.

4. Once the renal fibrosis is activated, it will release a series of toxic cell factors and growth factors.

5. Renal toxic factors can lead to phenotype switch of renal functional cells.

6. Due to increased ECM, it will disturb the dynamic balance mechanism of ECM formation and degradation, which results in increased ECM formation and decreased degradation. Eventually it lead to massive deposition and accumulation of extracellular matrix.

7. Because of deposition and accumulation, build up of ECM replace healthy renal function, leading to hardening glomeruli and renal tubular-interstitial fibrosis and arterial damage fibrosis.

8. With the progress of renal fibrosis, functional kidney nephrons decreases gradually and kidney function will decline. Finally fibrosis will become scarring tissues, functional kidney nephrons will all be damaged and lose their ability. Kidneys in clinic will develop end stage renal failure-uremia.