The physical basis of renal fibrosis: Effects of altered hydrodynamic forces on kidney homeostasis

Research output: Contribution to journalReview article

Abstract

Healthy kidneys are continuously exposed to an array of physical forces as they filter the blood: shear stress along the inner lumen of the tubules, distension of the tubular walls in response to changing fluid pressures, and bending moments along both the cilia and microvilli of individual epithelial cells that comprise the tubules. Dysregulation of kidney homeostasis via underlying medical conditions such as hypertension, diabetes, or glomerulonephritis fundamentally elevates the magnitudes of each principle force in the kidney and leads to fibrotic scarring and eventual loss of organ function. The purpose of this review is to summarize the progress made characterizing the response of kidney cells to pathological levels of mechanical stimuli. In particular, we examine important, mechanically responsive signaling cascades and explore fundamental changes in renal cell homeostasis after cyclic strain or fluid shear stress exposure. Elucidating the effects of these disease-related mechanical imbalances on endogenous signaling events in kidney cells presents a unique opportunity to better understand the fibrotic process.

Original languageEnglish (US)
Pages (from-to)F473-F485
JournalAmerican Journal of Physiology - Renal Physiology
Volume306
Issue number5
DOIs
StatePublished - Mar 1 2014

Keywords

  • Chronic kidney disease
  • EMT
  • Fibrosis
  • Mechnotransduction
  • TGF-β1

ASJC Scopus subject areas

  • Physiology
  • Urology

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