Chronic kidney disease (CKD) is a significant health problem that most commonly results from
congenital abnormalities in children and chronic renal injury in adults. The therapeutic potential of
BMP-7 was first recognized nearly two decades ago with studies demonstrating its requirement for kidney development and ability to inhibit the pathogenesis of renal injury in models of CKD. Since this time, our understanding of CKD has advanced considerably and treatment strategies have evolved with the identification of many additional signaling pathways, cell types, and
pathologic processes that contribute to
disease progression. The purpose of this review is to revisit the seminal studies that initially established the importance of
BMP-7, highlight recent advances in
BMP-7 research, and then integrate this knowledge with current research paradigms. We will provide an overview of the evolutionarily conserved roles of BMP
proteins and the features that allow BMP signaling pathways to function as critical signaling nodes for controlling biological processes, including those related to CKD. We will discuss the multifaceted functions of
BMP-7 during kidney development and the potential for alterations in
BMP-7 signaling to result in
congenital abnormalities and pediatric
kidney disease. We will summarize the renal protective effects of recombinant
BMP-7 in experimental models of CKD and then propose a model to describe the potential physiological role of endogenous
BMP-7 in the innate repair mechanisms of the kidneys that respond to renal injury. Finally, we will highlight emerging clinical approaches for applying our knowledge of
BMP-7 toward improving the treatment of patients with CKD.