Why do damaged kidneys develop inflammation and fibrosis?

In the context of chronic kidney disease, inflammation and fibrosis are driven by the ongoing deterioration of nephron function.

As nephrons are lost, the remaining functional units attempt to compensate through processes known as nephron hyperfiltration and compensatory hypertrophy. While these mechanisms initially help maintain kidney function, they become maladaptive over time. The resulting elevated pressure and increased workload overwhelm the filtering structures, leading to further nephron damage and death.12

This cycle of deterioration promotes inflammation and the development of fibrosis, which causes the kidney tissue to become stiff. This increased mechanical stiffness further impairs the organ's ability to eliminate metabolic wastes and regulate blood pressure and electrolytes, creating a self-perpetuating cycle of injury and structural decline.12