Predicting initiation and progression of chronic kidney disease: Developing renal risk scores

• Published in: Kidney international Vol. 70; no. 10; pp. 1694 - 1705
• Main Authors: Taal, M.W., Brenner, B.M.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-11-2006; Nature Publishing; Elsevier Limited
• Subjects: Biological and medical sciences; Biomarkers - urine; Cardiovascular Diseases - etiology; Cardiovascular Diseases - physiopathology; Chronic Disease; chronic kidney disease; Disease Progression; Epidemiology; epidemiology and outcomes; Female; General aspects; Humans; Kidney Diseases - diagnosis; Kidney Diseases - etiology; Kidney Diseases - physiopathology; Kidney Diseases - urine; Kidney Failure, Chronic - physiopathology; Kidneys; Male; Medical sciences; Nephrology. Urinary tract diseases; Prognosis; Public health. Hygiene; Public health. Hygiene-occupational medicine; renal progress; renal protection; Risk Factors; Urinary system involvement in other diseases. Miscellaneous; renal protection; risk factors; chronic kidney disease; epidemiology and outcomes; renal progress; Kidney disease; Nephrology; Urinary system disease; Prognosis; Chronic kidney disease; Risk analysis; Epidemiology; Urology; Renal failure; Risk factor; Evolution; Initiation; Protection
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1038/sj.ki.5001794

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. Prospective studies have identified risk factors for CKD in the general population as well as risk factors for progression in patients with established CKD. Risk factors may thus be divided into initiating factors and perpetuating factors, with some overlap between the groups. 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.