Obstructive uropathies are a group of conditions characterized by urinary tract blockages, leading to impaired urine flow and renal damage. This comprehensive literature review aims to explore the pathophysiological mechanisms underlying renal damage in obstructive uropathies and identify potential therapeutic targets for intervention. The review synthesizes current knowledge from a wide range of studies and provides an overview of the complex cellular and molecular processes involved in renal damage progression, including hemodynamic alterations, oxidative stress, interstitial inflammation, and tubulointerstitial fibrosis. Key players in the pathogenesis of renal damage, such as the renin-angiotensin-aldosterone system, reactive oxygen species, immune cells, and fibrogenic factors, are discussed in detail. Furthermore, potential therapeutic targets, including renin-angiotensin inhibitors, antioxidants, anti-inflammatory agents, and antifibrotic strategies, are identified based on preclinical and experimental studies. Additionally, emerging therapeutic modalities like mesenchymal stem cells and extracellular vesicles derived from MSCs are explored for their potential in attenuating renal damage and promoting tissue repair. Understanding the pathophysiological mechanisms and identifying potential therapeutic targets is crucial for the development of effective interventions to mitigate renal damage in obstructive uropathies, ultimately improving patient outcomes and quality of life. Further research and clinical trials are needed to translate these promising findings into clinical practice and address the unmet therapeutic needs in this patient populatio
