Albuminuria: Time to focus on accuracy

摘要

Albuminuria is common in chronic kidney disease (CKD). It is often the earliest marker of kidney damage and, in many circumstances, precedes any decline in glomerular filtration rate (GFR). The recent Kidney Disease: Improving Global Outcomes (KDI-GO) guideline for the Evaluation and Management of Chronic Kidney Disease revised the classification system for CKD to include both albuminuria level and GFR for staging the severity of CKD.1 This revision was based in part on data from large scale meta-analyses of studies of people with and without CKD that demonstrated the prognostic importance of albuminuria for kidney disease outcomes as well as for cardiovascular disease and mortality. " The level of albuminuria is also relevant for management decisions. Patients with elevated levels of albuminuria may benefit from lower blood pressure targets and medications that block the renin angiotensin system, and in patients with nephrotic syndrome, physicians initiate therapy and monitor its response by the level of albuminuria or proteinuria.6