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Editorial Review
Biochemical risk markers: a novel area for better prediction of renal risk?
1 Internal Medicine, 2 Trial Coordination Center, 3 Nephrology and 4 Clinical Pharmacology, University Hospital Groningen, Groningen, The Netherlands
Correspondence and offprint requests to: D. de Zeeuw, MD PhD, Professor and Head, Department of Clinical Pharmacology, University Medical Center, Ant. Deusinglaan 1, 9713 AV, PO Box 196, Groningen, The Netherlands. E-mail: d.de.zeeuw@med.rug.nl
Keywords: acute phase proteins; albuminuria; atherosclerosis; C-reactive protein; cardiovascular risk factors; chronic kidney failure
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Introduction |
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Prevention of end-stage renal disease (ESRD) by early detection and treatment is an important tool to stop the growing need for renal replacement therapy. The last decade has brought forward strong reasons for such an approach. The incidence of ESRD has increased dramatically, which is mostly attributed to type 2 diabetes [1] and improved survival from atherosclerotic vascular disease [2]. This increased rate of ESRD further augments the already high burden on the patient and doctor, as well as on health care economics. Indeed, patients entering a renal replacement programme are 15 times more likely to die relative to subjects in the general population.
The target population for prevention still needs to be defined. There is no doubt that prevention in patients with glomerulonephritis, pyelo- and interstitial nephritis and diabetic renal disease is feasible. For non-diabetic subjects, logical steps are to identify those who are also
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Markers of inflammation |
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C-reactive protein and CV outcome
CRP: mechanisms of CV outcome
CRP: mechanisms in renal outcome
CRP as a predictor of renal outcome—GFR
General population
Chronic kidney disease
Diabetes
CRP as a predictor of renal outcome—albuminuria
Chronic kidney disease
Diabetes
Conclusion
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Markers of endothelial function |
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Microalbuminuria
Albuminuria and CV outcome
Albuminuria: mechanisms of CV outcome
Albuminuria as a predictor of renal outcome—GFR in the general population
Albuminuria as a predictor of renal outcome—GFR in diabetes
Baseline albuminuria as a predictor of albuminuria progression in the general population
Baseline albuminuria as a predictor of albuminuria progression in diabetes
Conclusion
von Willebrand factor
vWF and CV outcome
vWF: mechanisms of CV outcome
vWF: mechanisms and predictive value in renal outcome—GFR in the general population
vWF: mechanisms and predictive value in renal outcome—GFR in diabetes
vWF: mechanisms and predictive value in renal outcome—albuminuria in the general population
vWF: mechanisms and predictive value in renal outcome—albuminuria in diabetes
Conclusion
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Other markers |
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Markers of cellular leukocyte adhesion
Markers of coagulation and fibrinolysis
Conclusion
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Biochemical risk markers: do we need them all? |
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Drug effects on novel risk markers |
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C-reactive protein
Albuminuria
von Willebrand factor
Leukocyte adhesion molecules
Plasminogen activator inhibitor-1
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Conclusions |
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