How is fibrosis inhibited in chronic glomerulonephritis?

Updated: Feb 24, 2020
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Because progressive fibrosis is the hallmark of chronic glomerulonephritis, some investigators have focused on finding inhibitors of fibrosis in an attempt to slow progression. Of the many compounds that have been considered, pirfenidone, an inhibitor of transforming growth factor beta and hence of collagen synthesis, has emerged as the best candidate.

Cho et al, in an open-label study involving 21 patients with idiopathic and postadaptive focal segmental glomerulosclerosis, found that pirfenidone yielded a median 25% improvement in the rate of decline of the estimated GFR; the drug did not affect proteinuria or blood pressure. [19] Among the adverse events attributed to therapy were dyspepsia, sedation, and photosensitive dermatitis. It is hoped that pirfenidone therapy will prove an effective means of slowing progressive fibrosis; however, more studies are needed.


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