Table 1.

Pathogenic mechanisms that contribute to progressive CKD.

Mechanism Underlying CKD ProgressionVariables
Nephron loss (acquired or hereditary)Birth prematurity, genetic factors, primary renal disease, age, episodes of AKI, nephrotoxins
Hemodynamic responses to nephron lossGlomerular hypertension, systemic blood pressure, glomerular hyperfiltration
InflammationCirculating or renal proinflammatory cytokines (e.g., TNF-α, IL-6)
FibrosisProfibrotic cytokines (e.g., TGF-α, AGE, angiotensin II)
  • CKD: chronic kidney disease; AKI: acute kidney injury; TNF: tumor necrosis factor; IL: interleukin; TGF: transforming growth factor; AGE: advanced glycation end products.