text: Obstructive nephropathy: lessons from cystic kidney disease.
  Obstructive nephropathy is one of the most important causes of renal failure in infants and children, while polycystic kidney disease (PKD) is a major cause of renal failure in the adult population. This review summarizes the evidence that there may be a number of mechanisms common to the pathophysiology of both conditions. In animal models of obstructive nephropathy and PKD, the renal tubular expression of epidermal growth factor is suppressed, and expression of clusterin is increased, both of which suggest arrested maturation or dedifferentiation of the tubular cell. There is a marked increase in apoptosis of epithelial cells in dilated tubules, associated with an increase in apoptotic stimuli. The renin-angiotensin system is activated in both obstructive nephropathy and PKD, which may contribute to tubular atrophy and interstitial fibrosis, which characterize the progression of both conditions. Focal cystic dilatation of the tubule is found in obstructive nephropathy, while tubular obstruction is present in cystic kidney disease. It is therefore likely that elucidation of the effects of mechanical stretch on renal tubular epithelial cells will contribute to our understanding of both conditions.
  
entities.text: ['kidney']
entities.type: Organ
entities.entity_id: PMID-10644902_T1
entities.text: ['kidney']
entities.type: Organ
entities.entity_id: PMID-10644902_T2
entities.text: ['renal tubular']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-10644902_T3
entities.text: ['tubular cell']
entities.type: Cell
entities.entity_id: PMID-10644902_T4
entities.text: ['epithelial cells']
entities.type: Cell
entities.entity_id: PMID-10644902_T5
entities.text: ['tubules']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-10644902_T6
entities.text: ['tubule']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-10644902_T7
entities.text: ['tubular']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-10644902_T8
entities.text: ['kidney']
entities.type: Organ
entities.entity_id: PMID-10644902_T9
entities.text: ['renal tubular epithelial cells']
entities.type: Cell
entities.entity_id: PMID-10644902_T10
entities.text: ['renal']
entities.type: Organ
entities.entity_id: PMID-10644902_T11
entities.text: ['renal']
entities.type: Organ
entities.entity_id: PMID-10644902_T12
entities.text: ['tubular']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-10644902_T13
entities.text: ['interstitial']
entities.type: Immaterial_anatomical_entity
entities.entity_id: PMID-10644902_T14