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

被引:204
作者
Taal, M. W.
Brenner, B. M.
机构
[1] Univ Nottingham, Derby City Gen Hosp, Derby Hosp NHS Fdn Trust, Dept Renal Med, Derby DE22 3NE, England
[2] Univ Nottingham, Derby City Gen Hosp, Ctr Integrated Syst Biol & Med, Derby DE22 3NE, England
[3] Brigham & Womens Hosp, Div Renal, Dept Med, Boston, MA 02115 USA
[4] Harvard Univ, Sch Med, Boston, MA 02115 USA
关键词
risk factors; renal protection; chronic kidney disease; epidemiology and outcomes; renal progress;
D O I
10.1038/sj.ki.5001794
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:1694 / 1705
页数:12
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