[Mechanisms of the progression of renal disease (risk factors)--part II].

A substantial number of renal diseases progress to renal failure although the initaial injury is no more active. Enhanced understanding of the diverse pathogenic me-chanisms involved in progression of renal disease has pointed to the three main factors which initiate and/or sustain this progress. These factors are: altered activity of intrinsic glo-merular cells, enhanced activity of mononuclear cells infiltrating glomerulus, and tubulointerstitial injury. In addition several potentional risk factors, such as disturbed glomerular haemodinamics, proteinuria, systemic hypertension, intraglomerular coagulation, hyperlipidaemia, dietary protein and phosphate, may contribute to progression of renal disease and renal failure. These risk factors are disscused in detail in this review. There is now strong evidence that in clinical practice good control of risk factors slow the progression of renal failure.