Are tubular cells not only victims but also perpetrators in renal fibrosis?

Renal fibrosis plays a major role in the progression of renal failure. Determining whether the tubule or the glomerulus is the initiating factor is made difficult by the complexity of disease processes. This Commentary discusses new findings by Grgic et al., who show that acute injury to the renal tubule is sufficient to produce the full spectrum of renal fibrosis.