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Proteinuric Biomarkers in Chronic Kidney Disease

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Biomarkers in Kidney Disease

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Abstract

Risk stratification of patients with chronic kidney disease is crucial for early identification of patients at risk of disease progression and for timely initiation of treatments to prevent progression and the associated cardiovascular morbidity and mortality. Proteinuria and its components have been widely used for diagnosis and staging system of chronic kidney diseases. Albuminuria is used for diagnosis of kidney disease in the general population and kidney involvement in systemic diseases such as diabetes. However, albuminuria is not the most powerful predictor of disease outcome, and the urinary excretion of proteins larger than albumin such as IgM and IgG shows a higher predictive value: IgM-uria could be helpful for kidney and cardiovascular risk assessment of diabetic patients, and IgG-uria could be helpful for risk assessment of glomerulonephritis patients. This chapter presents a concise review of the clinical value of proteinuria profile for prediction of functional outcome and responsiveness to treatments in patients with chronic kidney disease.

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Abbreviations

ACEi:

Angiotensin-converting enzyme inhibitors

α2m/C:

α2-macroglobulin/urinary creatinine ratio

Albumin/C:

Urinary albumin/urinary creatinine ratio

ANCA:

Antineutrophil cytoplasmic antibody

Anti-PLA2R:

Anti-phospholipase A2 receptor antibody

α1m:

α1-microglobulin

β2m:

β2-microglobulin

β-NAG:

N-acetyl-β-D-glucosaminidase

CKD:

Chronic kidney disease

CSA:

Cyclosporine A

CYC:

Cyclophosphamide

CV:

Cardiovascular

DM:

Diabetes mellitus

DKD:

Diabetic kidney disease

eGFR:

Estimated glomerular filtration rate

ESKD:

End-stage kidney disease

FE:

Fractional excretion

FE α1m:

Fractional excretion of α1-microglobulin

FE IgG:

Fractional excretion of immunoglobulin G

FSGS:

Focal segmental glomerulosclerosis

GBM:

Glomerular basement membrane

GCW:

Glomerular capillary wall

GFB:

Glomerular filtration barrier

GGS:

Global glomerular sclerosis

GN:

Glomerulonephritis

HR:

Hazard ratio

hsCRP:

High-sensitive C-reactive protein

IgA:

Immunoglobulin A

IgAN:

IgA nephropathy

IgG:

Immunoglobulin G

IgM:

Immunoglobulin M

IMN:

Idiopathic membranous nephropathy

MCD:

Minimal change disease

MPGN:

Membranoproliferative glomerulonephritis

MW:

Molecular weight

NS:

Nephrotic syndrome

PTECs:

Proximal tubular epithelial cells

RAS:

Renin-angiotensin system

ROC analysis:

Receiver-operating characteristic analysis

RTX:

Rituximab

sCr:

Serum creatinine

SDS-PAGE:

Sodium dodecyl sulfate polyacrylamide gel electrophoresis

SG:

Surviving glomeruli: glomeruli without global sclerosis

SI:

IgG/transferrin selectivity index

TID:

Tubulointerstitial damage

TGF-β:

Transforming growth factor β

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Authors and Affiliations

  1. D’Amico Foundation for Renal Disease Research, Via Cherubini, 6, 20145, Milan, Italy

    Claudio Bazzi

  2. Department of Nephrology, Lund University, Lund, Sweden

    Omran Bakoush

  3. Department of Internal Medicine, UAE University, Al Ain, United Arab Emirates

    Omran Bakoush

Authors
  1. Claudio Bazzi
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  2. Omran Bakoush
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Correspondence to Claudio Bazzi .

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Editors and Affiliations

  1. DeptofBiomedlSci,FacltyofSci&Technology, University of Westminster , London, United Kingdom

    Vinood B. Patel

  2. Department of Nutrition and Dietetics,Division of Diabetes and Nutritional Sciences, Faculty of Life Science and Medicine, King’s College London, London, United Kingdom

    Victor R. Preedy

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Bazzi, C., Bakoush, O. (2016). Proteinuric Biomarkers in Chronic Kidney Disease. In: Patel, V., Preedy, V. (eds) Biomarkers in Kidney Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7699-9_23

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