Kidney international
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Kidney international · Mar 2007
CommentMeasuring risk in end-stage renal disease: is N-terminal pro brain natriuretic peptide a useful marker?
Natriuretic peptides are important in the maintenance of body volume homeostasis. There has been interest in utilizing the levels of these peptides to diagnose and prognosticate cardiovascular disease. In end-stage renal disease, the diagnostic utility of these peptides is limited. Madsen et al. report that levels of N-terminal pro brain natriuretic peptide (NT-proBNP) levels offer important information on the risk of mortality in patients undergoing hemodialysis.
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Kidney international · Mar 2007
CommentRenal albumin handling: a look at the dark side of the filter.
Renal albumin handling is of major interest because albuminuria is an important risk factor for reno-cardiovascular diseases. In this issue a challenging study attempts to shift the paradigm of very low fractional albumin filtration and degradation in proximal tubule cells. The conclusions are of great potential relevance but require urgent validation so that we gain a clearer view of the dark side of the glomerular filter.
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Kidney international · Dec 2006
Comment ReviewComprehensive suppression of the renin-angiotensin-aldosterone system in chronic kidney disease: covering all of the bases.
Reducing proteinuria and blood pressure in chronic kidney disease (CKD) decreases rate of progression. Inhibition of the renin-angiotensin system by angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers is beneficial in reducing proteinuria but incomplete in suppressing aldosterone production and its renal effects. Adding aldosterone receptor blockers to these other agents may further halt the progression of CKD.
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Kidney international · Nov 2006
ReviewPredicting initiation and progression of chronic kidney disease: Developing renal risk scores.
Epidemiological studies have raised awareness of the problem of undiagnosed chronic kidney disease (CKD) and suggest that early identification and treatment will reduce the global burden of patients requiring dialysis. This has highlighted the twin problems of how to identify subjects for screening and target intervention to those with CKD most likely to progress to end-stage renal disease. ⋯ In this paper, we review current data regarding CKD risk factors and illustrate how each may impact upon the mechanisms underlying CKD progression to accelerate loss of renal function. We propose that these risk factors should be used as a basis for developing a renal risk score, analogous to the Framingham risk score for ischemic heart disease, which will allow accurate determination of renal risk in the general population and among CKD patients.