Etiology And Pathogenesis of Renal Failure

1, the changes of nephron hemodynamics: when renal parenchyma reduces, the remaining healthy nephron hemodynamics will be changed. The manifestation is the increase of glomerular capillary pressure and flow rate, that is glomerular hyperperfusion and hyperfiltration. In this case, the angiotensin in the kidney tissue will increase, causing hypertension, glomerular hypertrophy and eventually leading to glomerular sclerosis. In addition, AT-Ⅱ will get involved in the synthesis of extracellular matrix and various expression of inflammatory cytokines and then promote glomerulosclerosis.

2, the changes of glomerular basement membrane permeability: the diseased glomerular basement membrane will cause the leakage of large number of protein, leading to damage of glomerular epithelial cells and tubulointerstitial and then renal fibrosis and reduced renal unit.

3, lipid metabolism disorders: very low density lipoprotein (VLDL) and low-density lipoprotein (LDL) increases, promoting progressive glomerular sclerosis.

4, high renal tubular metabolism: when nephron reduces, renal tubular hypermetabolism can make free radicals of healthy kidney units increase. The decreased scavenging of free radical will lead to cell damage and further kidney units.