Abstract
Recent years have shown a variety of therapeutic approaches in advanced stages of chronic kidney disease and end-stage renal disease to fail to improve outcomes. Renal replacement therapy, while life-saving, has seen very little advances during the last two decades. Some investigators believe that in patients undergoing chronic renal replacement therapy, kidney disease and most importantly cardiovascular comorbidities have progressed past the point where any intervention can improve outcomes. Thus, the focus has shifted to very early stages of chronic kidney disease, which we hope to identify with new biomarkers. Those biomarkers could be of importance in defining a new disease, or at least a new stage of disease. It is common practice in other areas of medicine, where pre-stages like “prehypertension” and “prediabetes” are well known and defined entities that may entail therapeutic interventions and the definition of these pre-stages may thus improve outcomes. Whether “pre-CKD” can be accurately defined, and whether the detection of pre-CKD could provide a benefit to individuals in terms of early detection and intervention leading to a better survival is topic of this review.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Coresh J, et al. Prevalence of chronic kidney disease in the United States. JAMA. 2007;298:2038–47.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu C-Y. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–305.
Prischl FC, et al. Diabetes-related end-stage renal disease in Austria 1965–2013. Nephrol Dial Transplant. 2015;30:1920–7.
Nathan DM, et al. Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care. 2007;30:753–9.
Vasan RS, et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med. 2001;345:1291–7.
Chobanian AV, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–72.
Curhan GC. Prediabetes, prehypertension … is it time for pre-CKD? Clin J Am Soc Nephrol. 2010;5:557–9.
Lewington S, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–13.
Sundstrom J, Neovius M, Tynelius P, Rasmussen F. Association of blood pressure in late adolescence with subsequent mortality: cohort study of Swedish male conscripts. BMJ. 2011;342:d643.
Julius S, et al. Feasibility of treating prehypertension with an angiotensin-receptor blocker. N Engl J Med. 2006;354:1685–97.
Chamberlain JJ, et al. Pharmacologic therapy for type 2 diabetes: synopsis of the 2017 American Diabetes Association Standards of Medical Care in Diabetes. Ann Intern Med. 2017;166:572–8.
American Diabetes Association. Classification and diagnosis of diabetes mellitus. Diabetes Care. 2017;40:S11–24.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl. 2009;76:S1–130.
Hemmelgarn BR, et al. Relation between kidney function, proteinuria, and adverse outcomes. JAMA. 2010;303:423–9.
Moyer VA, U.S. Preventive Services Task Force. Screening for chronic kidney disease: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;157:567–70.
van der Velde M, de Jong PE, Gansevoort RT. Comparison of the yield of different screening approaches to detect chronic kidney disease. Nephrol Dial Transplant. 2010;25:3222–30.
Carville S, Wonderling D, Stevens P, Guideline Development G. Early identification and management of chronic kidney disease in adults: summary of updated NICE guidance. BMJ. 2014;349:g4507.
Wetzels JF, Kiemeney LA, Swinkels DW, Willems HL, den Heijer M. Age- and gender-specific reference values of estimated GFR in Caucasians: the Nijmegen Biomedical Study. Kidney Int. 2007;72:632–7.
Mattix HJ, Hsu C-Y, Shaykevich S, Curhan G. Use of the albumin/creatinine ratio to detect microalbuminuria: implications of sex and race. J Am Soc Nephrol. 2002;13:1034–9.
Tonneijck L, et al. Glomerular hyperfiltration in diabetes: mechanisms, clinical significance, and treatment. J Am Soc Nephrol. 2017;28:1023–39.
Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function—measured and estimated glomerular filtration rate. N Engl J Med. 2006;354:2473–83.
Levey AS, Stevens LA. Estimating GFR using the CKD Epidemiology Collaboration (CKD-EPI) creatinine equation: more accurate GFR estimates, lower CKD prevalence estimates, and better risk predictions. Am J Kidney Dis. 2010;55:622–7.
Wasung ME, Chawla LS, Madero M. Biomarkers of renal function, which and when? Clinica chimica acta. Int J Clin Chem. 2015;438:350–7.
Abrahamson M, Dalboge H, Olafsson I, Carlsen S, Grubb A. Efficient production of native, biologically active human cystatin C by Escherichia coli. FEBS Lett. 1988;236:14–8.
Hojs R, Bevc S, Ekart R, Gorenjak M, Puklavec L. Serum cystatin C as an endogenous marker of renal function in patients with mild to moderate impairment of kidney function. Nephrol Dial Transplant. 2006;21:1855–62.
Stevens LA, et al. Estimating GFR using serum cystatin C alone and in combination with serum creatinine: a pooled analysis of 3,418 individuals with CKD. Am J Kidney Dis. 2008;51:395–406.
Ribitsch W, et al. Neutrophil gelatinase-associated lipocalin (NGAL) fails as an early predictor of contrast induced nephropathy in chronic kidney disease (ANTI-CI-AKI study). Sci Rep. 2017;7:41300.
Kuncio GS, Neilson EG, Haverty T. Mechanisms of tubulointerstitial fibrosis. Kidney Int. 1991;39:550–6.
Mitsnefes MM, et al. Serum neutrophil gelatinase-associated lipocalin as a marker of renal function in children with chronic kidney disease. Pediatr Nephrol. 2007;22:101–8.
Smith ER, et al. Urinary neutrophil gelatinase-associated lipocalin may aid prediction of renal decline in patients with non-proteinuric stages 3 and 4 chronic kidney disease (CKD). Nephrol Dial Transplant. 2013;28:1569–79.
Bolignano D, et al. Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease. Clin J Am Soc Nephrol. 2009;4:337–44.
Ketteler M, et al. Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline update: what's changed and why it matters. Kidney Int. 2017;92:26–36.
Isakova T, Wolf MS. FGF23 or PTH: which comes first in CKD ? Kidney Int. 2010;78:947–9.
Gutierrez O, et al. Fibroblast growth factor-23 mitigates hyperphosphatemia but accentuates calcitriol deficiency in chronic kidney disease. J Am Soc Nephrol. 2005;16:2205–15.
Isakova T, et al. Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int. 2011;79:1370–8.
Isakova T, et al. Fibroblast growth factor 23 and risks of mortality and end-stage renal disease in patients with chronic kidney disease. JAMA. 2011;305:2432–9.
Dhingra R, et al. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch Intern Med. 2007;167:879–85.
Foley RN, Collins AJ, Ishani A, Kalra PA. Calcium-phosphate levels and cardiovascular disease in community-dwelling adults: the Atherosclerosis Risk in Communities (ARIC) Study. Am Heart J. 2008;156:556–63.
Gutiérrez OM, et al. Fibroblast growth factor 23 and mortality among patients undergoing hemodialysis. N Engl J Med. 2008;359:584–92.
Block GA, Hulbert-Shearon TE, Levin NW, Port FK. Association of serum phosphorus and calcium × phosphate product with mortality risk in chronic hemodialysis patients: a national study. Am J Kidney Dis. 1998;31:607–17.
The EVOLVE Trial Investigators. Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis. N Engl J Med. 2012;367:2482–94. https://doi.org/10.1056/NEJMoa1205624.
Raggi P, et al. The ADVANCE study: a randomized study to evaluate the effects of cinacalcet plus low-dose vitamin D on vascular calcification in patients on hemodialysis. Nephrol Dial Transplant. 2011;26:1327–39.
Blacher J, Guerin AP, Pannier B, Marchais SJ, London GM. Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension. 2001;38:938–42.
Moe SM, et al. Cinacalcet, fibroblast growth factor-23, and cardiovascular disease in hemodialysis: the Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) trial. Circulation. 2015;132:27–39.
Fliser D, et al. Fibroblast growth factor 23 (FGF23) predicts progression of chronic kidney disease: the Mild to Moderate Kidney Disease (MMKD) study. J Am Soc Nephrol. 2007;18:2600–8.
Gutiérrez OM, et al. Fibroblast growth factor 23 and left ventricular hypertrophy in chronic kidney disease. Circulation. 2009;119:2545–52.
Grabner A, et al. Activation of cardiac fibroblast growth factor receptor 4 causes left ventricular hypertrophy. Cell Metab. 2015;22:1020–32.
Mirza MA, et al. Relationship between circulating FGF23 and total body atherosclerosis in the community. Nephrol Dial Transplant. 2009;24:3125–31.
Evenepoel P, et al. Fibroblast growth factor-23 in early chronic kidney disease: additional support in favor of a phosphate-centric paradigm for the pathogenesis of secondary hyperparathyroidism. Clin J Am Soc Nephrol. 2010;5:1268–76.
Parker BD, et al. The associations of fibroblast growth factor 23 and uncarboxylated matrix Gla protein with mortality in coronary artery disease: the Heart and Soul Study. Ann Intern Med. 2010;152:640–8.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Kirsch, A.H., Rosenkranz, A.R. (2019). Pre-chronic Kidney Disease (CKD)? Is It Time for a New Staging?. In: Zimlichman, R., Julius, S., Mancia, G. (eds) Prehypertension and Cardiometabolic Syndrome. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-75310-2_16
Download citation
DOI: https://doi.org/10.1007/978-3-319-75310-2_16
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-75309-6
Online ISBN: 978-3-319-75310-2
eBook Packages: MedicineMedicine (R0)