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Biomarkers in chronic kidney disease: a review.

Authors
  • Fassett, Robert G
  • Venuthurupalli, Sree K
  • Gobe, Glenda C
  • Coombes, Jeff S
  • Cooper, Matthew A
  • Hoy, Wendy E
Type
Published Article
Journal
Kidney International
Publisher
Elsevier
Publication Date
Oct 01, 2011
Volume
80
Issue
8
Pages
806–821
Identifiers
DOI: 10.1038/ki.2011.198
PMID: 21697815
Source
Medline
License
Unknown

Abstract

Chronic kidney disease (CKD) is a major public health problem. The classification of CKD by KDOQI and KDIGO and the routine eGFR reporting have resulted in increased identification of CKD. It is important to be able to identify those at high risk of CKD progression and its associated cardiovascular disease (CVD). Proteinuria is the most sensitive marker of CKD progression in clinical practice, especially when combined with eGFR, but these have limitations. Hence, early, more sensitive, biomarkers are required. Recently, promising biomarkers have been identified for CKD progression and its associated CVD morbidity and mortality. These may be more sensitive biomarkers of kidney function, the underlying pathophysiological processes, and/or cardiovascular risk. Although there are some common pathways to CKD progression, there are many primary causes, each with its own specific pathophysiological mechanism. Hence, a panel measuring multiple biomarkers including disease-specific biomarkers may be required. Large, longitudinal observational studies are needed to validate candidate biomarkers in a broad range of populations prior to implementation into routine CKD management. Recent renal biomarkers discovered include neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, and liver-type fatty acid-binding protein. Although none are ready for use in clinical practice, it is timely to review the role of such biomarkers in predicting CKD progression and/or CVD risk in CKD.

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