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Review
. 2017 Mar 1;312(3):F375-F384.
doi: 10.1152/ajprenal.00266.2016. Epub 2016 Dec 14.

A perspective on chronic kidney disease progression

Jianyong Zhong  1   2 , Hai-Chun Yang  1   2 , Agnes B Fogo  3   2   4
Affiliations
Review

A perspective on chronic kidney disease progression

Jianyong Zhong et al. Am J Physiol Renal Physiol. .

Abstract

Chronic kidney disease (CKD) will progress to end stage without treatment, but the decline of renal function may not be linear. Compared with glomerular filtration rate and proteinuria, new surrogate markers, such as kidney injury molecule-1, neutrophil gelatinase-associated protein, apolipoprotein A-IV, and soluble urokinase receptor, may allow potential intervention and treatment in the earlier stages of CKD, which could be useful for clinical trials. New omic-based technologies reveal potential new genomic and epigenomic mechanisms that appear different from those causing the initial disease. Various clinical studies also suggest that acute kidney injury is a major risk for progressive CKD. To ameliorate the progression of CKD, the first step is optimizing renin-angiotensin-aldosterone system blockade. New drugs targeting endothelin, transforming growth factor-β, oxidative stress, and inflammatory- and cell-based regenerative therapy may have add-on benefit.

Keywords: acute kidney injury; genomic; regenerative therapy; surrogate marker.

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