Four danger response programs determine glomerular and tubulointerstitial kidney pathology

Figures & data

Figure 1. Traumatic injuries across species and kidney disease. Coordinated danger response programs are of benefit for multicellular organisms, even if they cause some collateral tissue damage or persisting defects. However, metabolic, hemodynamic or toxic factors rather hit the kidney in a diffuse manner which is why collateral damage affects the entire renal tissue and progresses to end-stage renal disease.

Table 1. Danger response programs and typical histopathologic abnormalities of the kidney

Program	Insufficient	Predominant
Clotting	Macrohematuria	Thrombotic microangiopathy Ischemic necrosis
Inflammation	Pathogen-related pathology	Immunopathology, necrosis, apoptosis, necroptosis (renal abcess formation, crescentic glomerulonephritis, allograft rejection, interstitial nephritis, acute tubular necrosis)
Epithelial healing	FSGS, glomeruloscerosis Tubular atrophy	Crescentic glomerulonephritis Podocytes pushed into catastrophic mitosis Cyst formation, chronic vasculopathies
Mesenchymal healing	Mesangiolysis	Mesangioproliferative glomerulonephritis Glomerulosclerosis Interstitial fibrosis, hypertensive vasculopathy