Biomarkers May Help Predict Chronic Kidney Disease

Circulating homocysteine, aldosterone, BNP aid in pointing to later CKD, microalbuminuria

MONDAY, Oct. 25 (HealthDay News) -- A panel including circulating homocysteine and several other biomarkers may help predict risk of chronic kidney disease (CKD) and microalbuminuria (MA), according to research published online Oct. 21 in the Journal of the American Society of Nephrology.

Caroline S. Fox, M.D., of the National Heart, Lung, and Blood Institute's Framingham Heart Study in Massachusetts, and colleagues analyzed data from 2,345 participants (mean age, 56.6 years) who attended the sixth Framingham Offspring Study examination during 1995 to 1998. Participants were followed for an average of 9.5 years, during which time, 213 developed CKD and 186 developed MA.

The researchers found that a panel consisting of C-reactive protein, aldosterone, renin, B-type natriuretic peptide (BNP), plasminogen-activator inhibitor type 1, fibrinogen, and homocysteine was associated with incident CKD and MA. In particular, homocysteine and aldosterone were significantly associated with incident CKD, and these and BNP were significantly associated with incident MA. These biomarkers improved risk prediction for both conditions, resulting in a 7 percent increase in net risk reclassification.

"These data suggest that newer biomarkers may improve our ability to identify individuals at greater risk for the development of renal disease (CKD or MA) up to 10 years before its clinical onset. More importantly, these findings identify potential pathways that may be involved in the pathogenesis of CKD and MA," the authors write.

Abstract
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