From secondary to primary prevention of progressive renal disease: the case for screening for albuminuria.

Abstract:

:Many subjects nowadays present with end-stage renal failure and its attendant cardiovascular complications without known prior renal damage. In this report we review the evidence available to strongly suggest that the present practice of secondary prevention in those with known prior renal disease should be extended to primary prevention for those subjects in the general population who are at risk for progressive renal failure, but who had never suffered from a primary renal disease. We show that such subjects can be detected by screening for albuminuria. Elevated urinary albumin loss is an indicator not only of poor renal, but also of poor cardiovascular prognosis. In addition to diabetic subjects who are at risk for albuminuria, we also show that hypertensive, obese, and smoking subjects are more susceptible. We suggest that therapies that have been shown to lower albumin excretion, such as ACE inhibitors, angiotensin II receptor antagonists, and statins be started early in such patients to prevent them from developing clinical renal disease and its attendant cardiovascular complications.

journal_name

Kidney Int

journal_title

Kidney international

authors

de Jong PE,Brenner BM

doi

10.1111/j.1523-1755.2004.66001.x

subject

Has Abstract

pub_date

2004-12-01 00:00:00

pages

2109-18

issue

6

eissn

0085-2538

issn

1523-1755

pii

S0085-2538(15)50315-3

journal_volume

66

pub_type

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