Signature of renal damage
Current clinical guidelines for the diagnosis and treatment of kidney diseases are focussing mainly on kidney function as the main parameter to detect and monitor disease progression. However, renal damage in the form of tissue remodeling, like fibrosis, can be found prior to a decline in renal function. Tissue remodeling is therefore an interesting field of research in order to find precise and early predictors of disease progression. This thesis focuses on (tubulo-interstitial) tissue remodeling as the signature of renal damage. First, our aim is to evaluate different triggers of tissue remodeling, like sodium intake, proteinuria and blood pressure. Next, tissue remodeling as a whole is dissected in different routes of inflammation, fibrosis and lymphangiogenesis. The interplay between these routes is being investigated as possible target for treatment. Finally, we evaluate the possibilities to clinically monitor tissue remodeling by detecting renal damage at an early stage and in this way prevent disease progression.