The renal lymphatic system is cardinal in circulatory physiology and immunology. Sakamoto et al. report that lymphatic angiogenesis is increased in tubulointerstitial lesions in human chronic renal disease and correlates with tissue damage. Moreover, lymphatic growth was associated with vascular endothelial growth factor-C (VEGF-C) expression in mononuclear and tubular epithelial cells. Diabetic nephropathy had the highest level of VEGF-C and the most extensive lymphangiogenesis. The data suggest that lymphangiogenesis is a common feature in the progression of tubulointerstitial fibrosis.