Chronic kidney disease is an important medical and social problem that has a significant impact on disability and mortality worldwide. Progressive tubulointerstitial fibrosis is the heart of this pathology. It does not depend on the type of nephropathy. Аccording to multiple studies, there is a strong correlation between tubulointerstitial fibrosis and decrease of glomerular filtration rate. The question about chronic kidney disease progression has been occupying one of the leading positions for several decades, because there is an urgent need to develop new diagnostic and treatment methods for management of CKD. This article discusses possible mechanisms for the progression of chronic kidney diseases, namely hemodynamic factors, proteinuria, the effects of hypoxia, the renin-angiotensin-aldosterone system, the epithelial-mesenchymal transition, as well as a number of growth factors.

Keywords: epithelial-mesenchymal transformation, tubulointerstitial fibrosis, renin-angiotensin-aldosterone system, chronic kidney disease, hypoxia