Review article

Biomarkers of clinical outcomes in advanced chronic kidney disease

Csaba Kovesdy, Kamyar Kalantar-Zadeh

Research output: Contribution to journalReview article

22 Citations (Scopus)

Abstract

Chronic kidney disease (CKD) is a complex condition, where the decrease in kidney function is accompanied by numerous metabolic changes affecting virtually all the organ systems of the human body. Many of the biomarkers characteristic of the individually affected organ systems have been associated with adverse outcomes including higher mortality in advanced CKD, whereas in persons without CKD these biomarkers may have no bearing on survival. It is believed that the high mortality seen in CKD is a result of several abnormalities conspiring to induce or aggravate a heightened degree of cardiovascular morbidity and predisposition to wasting syndrome. Not all the biomarkers may, however, be causally responsible for the adverse outcomes associated with them. We review various biomarkers of protein-energy wasting, inflammation, oxidative stress, potassium disarrays, acid-base disorders, bone and mineral disorders, glycemic status, and anemia. Although all of these biomarkers have shown associations with worsened outcomes in CKD, markers of protein-energy wasting, especially serum albumin, remain the strongest predictor of survival in CKD patients, especially those undergoing maintenance dialysis treatment. We also review the putative pathophysiologic mechanisms behind these associations, and present potential therapeutic interventions that could result in remedies to improve poor clinical outcomes in CKD, pending the results of current and future controlled trials.

Original languageEnglish (US)
Pages (from-to)408-415
Number of pages8
JournalNephrology
Volume14
Issue number4
DOIs
StatePublished - Jun 1 2009

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Chronic Renal Insufficiency
Biomarkers
Wasting Syndrome
Survival
Mortality
Human Body
Serum Albumin
Minerals
Anemia
Dialysis
Potassium
Proteins
Oxidative Stress
Maintenance
Inflammation
Morbidity
Kidney
Bone and Bones
Acids
Therapeutics

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Review article : Biomarkers of clinical outcomes in advanced chronic kidney disease. / Kovesdy, Csaba; Kalantar-Zadeh, Kamyar.

In: Nephrology, Vol. 14, No. 4, 01.06.2009, p. 408-415.

Research output: Contribution to journalReview article

Kovesdy, Csaba ; Kalantar-Zadeh, Kamyar. / Review article : Biomarkers of clinical outcomes in advanced chronic kidney disease. In: Nephrology. 2009 ; Vol. 14, No. 4. pp. 408-415.
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