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Albuminuria

all you need to predict outcomes in chronic kidney disease?
Authors: Gansevoort, Ron T.; Nauta, Ferdau L.; Bakker, Stephan J. L.;
Abstract

Purpose of reviewScreening for chronic kidney disease frequently starts with assessment of estimated glomerular filtration rate (eGFR). In current approaches, further evaluation will only include measurement of albuminuria in case of eGFR less than 60 ml/min/1.73m(2). We will review whether this screening approach is correct.Recent findingsAlbuminuria is an important predictor of both cardiovascular and kidney outcomes in chronic kidney disease. The predictive value of albuminuria for these endpoints is not only independent of well known risk factors, including diabetes and hypertension, but it is also independent of eGFR. Many individuals with normal eGFR have albuminuria. More research is needed to define why albuminuria adds to eGFR in predicting outcomes. After leakage through the glomerular filter, albumin is not only excreted in urine, but also reabsorbed by tubules. Albuminuria may, therefore, be a marker of both glomerular and tubular damage, whereas eGFR is merely a marker of glomerular damage.SummaryAs many individuals with an eGFR more than 60 ml/min/1.73m(2) have microalbuminuria, and albuminuria is an independent predictor of both renal and cardiovascular outcomes, screening for chronic kidney disease should at least include measurement of albuminuria. Future studies should consider whether the inclusion of (other) markers of tubular damage will further improve our ability to predict outcomes in patients with chronic kidney disease.

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Keywords

GENERAL-POPULATION, end-stage renal disease, NEPHROPATHY, MORTALITY, RISK SCORES, PROTEINURIA, ALL-CAUSE, albuminuria, DIABETIC-PATIENTS, dipstick, COST-EFFECTIVENESS, MILD RENAL-INSUFFICIENCY, cardiovascular disease, tubular protein transport, eGFR, proteinuria, CARDIOVASCULAR EVENTS, chronic kidney disease

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
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