Pharmacological intervention in renal fibrosis and vascular sclerosis.

Progressive renal disease is associated with the development of fibrosing lesions not only in the glomerulus, but also in the interstitial and vascular compartments of the kidney. A growing body of work suggests that the mechanisms involved in this process are to a large extent shared by the glomerular mesangial cell, tubulointerstitial fibroblast and vascular smooth muscle cell. In this review we consider evidence that treatment strategies focused on any one of these cells are likely to be of universal benefit in the abrogation of the ongoing scarring that accompanies progressive renal disease, while at the same time reducing the progressive vascular sclerosis so often ultimately responsible for the excessive mortality seen in patients with renal failure.