The role of vascular endothelial growth factor in renal diseases

Vascular endothelial growth factor (VEGF) is crucial for vascular growth, maintenance of vascular permeability and prolongation of the survival of endothelial cell. VEGF is expressed in the kidney, especially in glomerular podocytes and tubular cells. Adequate amount of VEGF is essential to maintain normal renal physiology. Excessive or defective expression of VEGF may cause renal disease. VEGF is involved in the pathophysiology of several renal diseases, and the most studied is diabetic nephropathy. Hyperglycemia may increase VEGF expression, however, nitric oxide, the downstream mediator of VEGF, is inhibited in diabetes. Thus, the excessive VEGF may play a detrimental role in the diabetic nephropathy. However, the role of VEGF inhibitor in the treatment of diabetic nephropathy remains elusive. In other renal disease, VEGF contributes to the restoration in acute renal failure and mesangioproliferative glomerulonephritis but is deleterious in chronic allograft nephropathy. Currently, the significance of VEGF and polymorphism of the VEGF gene in renal diseases attract more and more attention, but efforts should be made to elucidate the detailed mechanism in the pathophysiology to facilitate the clinical application of VEGF pathway in renal diseases.