Based on the Oxford Textbook of Clinical Nephrology and companion to the Oxford Handbook of Dialysis, this handbook provides clear information and practical advice about the day-to-day management of patients with renal disease.

This book systemically presents the latest research on renal fibrosis, covering all the major topics in the field, including the possible mechanisms, biomarkers, and strategies for prevention and treatment of chronic kidney disease (CKD). Due to its high prevalence, CKD represents a huge global economic and social burden. Irrespective of the initial causes, CKD progresses to end stage kidney disease (ESKD) due to renal fibrosis, which is characterized by glomerulosclerosis, tubule atrophy and atresia, and the excessive accumulation of extracellular matrix (ECM) in the kidney. Unfortunately, an estimated 1%-2% of the adult population living with CKD will need renal replacement therapy at some point as a result of ESKD. As such, strategies for preventing or slowing CKD progression to ESKD are of utmost importance, and studies aiming to understand the mechanisms of renal fibrosis have been the focus of intensive research. Recently, novel insights into the pathophysiological processes have furthered our understanding of the pathogenesis of renal fibrosis, and more importantly, promoted studies on the early diagnosis and treatment of CKD. This book draws lessons from the extensive, state-of-the-art research in this field, elaborating the new theories and new techniques to offer readers a detailed and comprehensive understanding of renal fibrosis and as well as inspiration for future research directions.

With contributions by numerous experts

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a highly prevalent hereditary renal disorder in which fluid-filled cysts are appeared in both kidneys. Main causative genes of ADPKD are PKD1 and PKD2, encoding for polycystin-1 (PC1) and polycystin-2 (PC2) respectively. Those proteins are localized on primary cilia and function as mechanosensor in response to the fluid flow, translating mechanistic stimuli into calcium signaling. With mutations either of PKD1 or PKD2, hyper-activated renal tubular epithelial cell proliferation is observed, followed by disrupted calcium homeostasis and aberrant intracellular cyclic AMP (cAMP) accumulation. Increased cell proliferation with fluid secretion leads to the development of thousands of epithelial-lined, fluid-filled cysts in kidneys. It is also accompanied by interstitial inflammation, fibrosis, and finally reaching end-stage renal disease (ESRD). In human ADPKD, the age at which renal failure typically occurs is later in life, however no specific targeted medications are available to cure ADPKD. Recently, potential therapeutic targets or surrogate diagnostic biomarkers for ADPKD are proposed with the advances in the understanding of ADPKD pathogenesis, and some of them were attempted for clinical trials. Herein, we will summarize genetic and epi-genetic molecular mechanisms in ADPKD progression, and overview the currently available biomarkers or potential therapeutic reagents suggested.

This publication provides a synopsis of the rapid progress made in the field of renal cell biology during the last decade, progress which has resulted in a better conceptual understanding of the cellular and molecular mechanisms of fibrotic renal disease. These developments have provided new therapeutic choices and led to the discovery of gene-based therapeutic options. The topics covered in this book have been carefully selected from the immense number of aspects of the disease to provide essential information on the molecular basis of renal fibrosis. Individual chapters discuss topics such as proteinuria and tubulointerstitial injury, the roles and regulation of TGF-beta, chemokines, oxidant stress, matrix remodeling, significance of renal expression of NF-kappa, and the potential impact of cell death in renal fibrosis.Written so as to present the complex information as simply as possible, this publication will be a very useful tool for general health professionals involved in the fields of immunology and cell biology, as well as for clinicians and researchers within the fields of nephrology, pathology and matrix biology.

An algorithmic approach to interpreting renal pathology, updated in light of recent advances in understanding and new classification schemes.