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Clinical Practice: Editorial

Free Access

Evaluation of Renal Function and Renal Risk in the Twenty-First Century

Porrini E.a · Warnock D.G.b

Author affiliations

aCentre for Biomedical Research of the Canary Islands (CIBICAN), Instituto de Tecnologías Biomédicas (ITB), University of La Laguna, Santa Cruz de Tenerife, Spain; bDepartment of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

Corresponding Author

Dr. David G. Warnock

Department of Medicine, University of Alabama at Birmingham

Room 614 ZRB, 1720 2nd Avenue South

Birmingham, AL 35294-0007 (USA)

E-Mail dwarnock@uabmc.edu

Related Articles for ""

Nephron 2017;136:261-262

The global increase of obesity and type 2 diabetes has epidemic proportions. Worldwide, an estimated 2.16 billions subjects are overweight or obese and 382 million people have diabetes, a number that will rise to 592 million by 2,035. This pandemic may portend severe consequences in Nephrology. In parallel, a world-wide “epidemic” of chronic kidney disease (CKD) has been described [1], based, in part, on epidemiological studies interpreted to show an increasing frequency of CKD in the general population, using serum and urinary biomarkers thought to reliably identify subjects with CKD [2]. This phenomenon is directly related to the classification and staging of CKD in 2002, introduced by the National Kidney Foundation Kidney Outcomes Quality Improvement (KDOQI) program [3]. The classification scheme has been more recently updated to include risk strata for albuminuria [4].

Estimated glomerular filtration rate is the foundation for the KDOQI and KDIGO classification of CKD, but the validity of this approach using a single filtration marker (e.g., serum creatinine) has always been an issue when these approaches are applied beyond the validation populations included in the CKD Epidemiology Collaboration [5]. These concerns are especially relevant to obese and diabetics patients for whom the estimating coefficients for creatinine generation, which are based on age, gender and race may simply not be accurate. In accordance, new markers of renal damage that allows detecting early renal disease in diabetes and obesity are urgently needed.

These issues provided a major theme at the CME course sponsored by the DIABESITY Working Group of the European Renal Association/European Dialysis and Transplantation Association, which was held at The Clinical Research Center for Rare Diseases “Aldo e Cele Daccò,” in Ranica, Bergamo, Italy December 4 and 5, 2015 http://www.marionegri.it/Diabesity+Working+Group+Meeting/114126,News.html. This issue of Nephron includes a number of papers from this course [6,7,8,9,10,11,12,13] that address these issues as well as other important aspects of the diabetes and obesity nexus.


References

  1. Glassock RJ, Warnock DG, Delanaye P: The global burden of chronic kidney disease: estimates, variability and pitfalls. Nat Rev Nephrol 2017;13:104-114.
  2. Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, Van Lente F, Levey AS: Prevalence of chronic kidney disease in the United States. JAMA 2007;298:2038-2047.
  3. K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Am J Kidney Dis 2002;39:S1-S266.
  4. Group KDIGOKCW: KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 2013;suppl 3:1-150.
  5. Inker LA, Schmid CH, Tighiouart H, Eckfeldt JH, Feldman HI, Greene T, Kusek JW, Manzi J, Van Lente F, Zhang YL, Coresh J, Levey AS: Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med 2012;367:20-29.
  6. Castillo-Rodriguez E, Fernandez-Prado R, Martin-Cleary C, Pizarro-Sánchez MS, Sanchez-Niño MD, Sanz AB, Fernandez-Fernandez B, Ortiz A: Kidney injury marker 1 and neutrophil gelatinase-associated lipocalin in chronic kidney disease. Nephron 2016, DOI: 10.1159/000447649.
  7. Hornum M, Feldt-Rasmussen B: Glomerular filtration rate estimation in renal and non-renal solid organ transplantation. Nephron 2016, DOI: 10.1159/000447673.
  8. Praga M, Morales E: The fatty kidney: obesity and renal disease. Nephron 2016, DOI: 10.1159/000447674.
  9. Trevisan R, Dodesini AR: The hyperfiltering kidney in diabetes. Nephron 2016, DOI: 10.1159/000448183.
  10. Cortinovis M, Perico N, Remuzzi G: Should we still believe in randomized controlled trials in nephrology? Nephron 2016, DOI: 10.1159/000450618.
  11. Luis-Lima S, Porrini E: An overview of errors and flaws of estimated GFR versus true GFR in patients with diabetes mellitus. Nephron 2016, DOI: 10.1159/000453531.
  12. Warnock DG, Delanaye P, Glassock RJ: Risks for all-cause mortality: stratified by age, estimated glomerular filtration rate and albuminuria. Nephron 2017, DOI: 10.1159/000455197.
  13. Hornum M, Feldt-Rasmussen B: Drug dosing and estimated renal function - any step forward from Effersoe? Nephron 2017, DOI: 10.1159/000456621.

Author Contacts

Dr. David G. Warnock

Department of Medicine, University of Alabama at Birmingham

Room 614 ZRB, 1720 2nd Avenue South

Birmingham, AL 35294-0007 (USA)

E-Mail dwarnock@uabmc.edu


Article / Publication Details

Published online: May 06, 2017
Issue release date: August 2017

Number of Print Pages: 2
Number of Figures: 0
Number of Tables: 0

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: http://www.karger.com/NEF


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References

  1. Glassock RJ, Warnock DG, Delanaye P: The global burden of chronic kidney disease: estimates, variability and pitfalls. Nat Rev Nephrol 2017;13:104-114.
  2. Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, Van Lente F, Levey AS: Prevalence of chronic kidney disease in the United States. JAMA 2007;298:2038-2047.
  3. K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Am J Kidney Dis 2002;39:S1-S266.
  4. Group KDIGOKCW: KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 2013;suppl 3:1-150.
  5. Inker LA, Schmid CH, Tighiouart H, Eckfeldt JH, Feldman HI, Greene T, Kusek JW, Manzi J, Van Lente F, Zhang YL, Coresh J, Levey AS: Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med 2012;367:20-29.
  6. Castillo-Rodriguez E, Fernandez-Prado R, Martin-Cleary C, Pizarro-Sánchez MS, Sanchez-Niño MD, Sanz AB, Fernandez-Fernandez B, Ortiz A: Kidney injury marker 1 and neutrophil gelatinase-associated lipocalin in chronic kidney disease. Nephron 2016, DOI: 10.1159/000447649.
  7. Hornum M, Feldt-Rasmussen B: Glomerular filtration rate estimation in renal and non-renal solid organ transplantation. Nephron 2016, DOI: 10.1159/000447673.
  8. Praga M, Morales E: The fatty kidney: obesity and renal disease. Nephron 2016, DOI: 10.1159/000447674.
  9. Trevisan R, Dodesini AR: The hyperfiltering kidney in diabetes. Nephron 2016, DOI: 10.1159/000448183.
  10. Cortinovis M, Perico N, Remuzzi G: Should we still believe in randomized controlled trials in nephrology? Nephron 2016, DOI: 10.1159/000450618.
  11. Luis-Lima S, Porrini E: An overview of errors and flaws of estimated GFR versus true GFR in patients with diabetes mellitus. Nephron 2016, DOI: 10.1159/000453531.
  12. Warnock DG, Delanaye P, Glassock RJ: Risks for all-cause mortality: stratified by age, estimated glomerular filtration rate and albuminuria. Nephron 2017, DOI: 10.1159/000455197.
  13. Hornum M, Feldt-Rasmussen B: Drug dosing and estimated renal function - any step forward from Effersoe? Nephron 2017, DOI: 10.1159/000456621.
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