Tubulointerstitial injury and the progression of chronic kidney disease

Kavita S. Hodgkins*, H. William Schnaper

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

147 Scopus citations


In chronic kidney disease (CKD), once injury from any number of disease processes reaches a threshold, there follows an apparently irreversible course toward decline in kidney function. The tubulointerstitium may play a key role in this common progression pathway. Direct injury, high metabolic demands, or stimuli from various other forms of renal dysfunction activate tubular cells. These, in turn, interact with interstitial tissue elements and inflammatory cells, causing further pathologic changes in the renal parenchyma. The tissue response to these changes thus generates a feed-forward loop of kidney injury and progressive loss of function. This article reviews the mechanisms of this negative cycle mediating CKD.

Original languageEnglish (US)
Pages (from-to)901-909
Number of pages9
JournalPediatric Nephrology
Issue number6
StatePublished - Jun 2012


  • Fibrosis
  • Hypoxia
  • Inflammation
  • Proteinuria

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health


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