Obstructive renal injury: from fluid mechanics to molecular cell biology

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Authors: Alvaro C Ucero, Sara Gonçalves, Alberto Benito-Martin, et al

Published Date April 2010 Volume 2010:2 Pages 41 - 55

DOI: http://dx.doi.org/10.2147/RRU.S6597

Alvaro C Ucero^1,*, Sara Gonçalves^2,*, Alberto Benito-Martin¹, Beatriz Santamaría¹, Adrian M Ramos¹, Sergio Berzal¹, Marta Ruiz-Ortega¹, Jesus Egido¹, Alberto Ortiz¹

¹Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Fundación Renal Iñigo Alvarez de Toledo, Madrid, Spain; ²Nefrologia e Transplantação Renal, Hospital de Santa Maria EPE, Lisbon, Portugal *Both authors contributed equally to the manuscript

Abstract: Urinary tract obstruction is a frequent cause of renal impairment. The physiopathology of obstructive nephropathy has long been viewed as a mere mechanical problem. However, recent advances in cell and systems biology have disclosed a complex physiopathology involving a high number of molecular mediators of injury that lead to cellular processes of apoptotic cell death, cell injury leading to inflammation and resultant fibrosis. Functional studies in animal models of ureteral obstruction using a variety of techniques that include genetically modified animals have disclosed an important role for the renin-angiotensin system, transforming growth factor-β1 (TGF-β1) and other mediators of inflammation in this process. In addition, high throughput techniques such as proteomics and transcriptomics have identified potential biomarkers that may guide clinical decision-making.

Keywords: urinary tract obstruction, renal injury, fluid mechanics, molecular cell biology

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