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      New Potential Biomarkers for Chronic Kidney Disease Management—A Review of the Literature

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          Abstract

          The prevalence of chronic kidney disease (CKD) is increasing worldwide, and the mortality rate continues to be unacceptably high. The biomarkers currently used in clinical practice are considered relevant when there is already significant renal impairment compromising the early use of potentially successful therapeutic interventions. More sensitive and specific biomarkers to detect CKD earlier on and improve patients’ prognoses are an important unmet medical need. The aim of this review is to summarize the recent literature on new promising early CKD biomarkers of renal function, tubular lesions, endothelial dysfunction and inflammation, and on the auspicious findings from metabolomic studies in this field. Most of the studied biomarkers require further validation in large studies and in a broad range of populations in order to be implemented into routine CKD management. A panel of biomarkers, including earlier biomarkers of renal damage, seems to be a reasonable approach to be applied in clinical practice to allow earlier diagnosis and better disease characterization based on the underlying etiologic process.

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          Most cited references174

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          K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification.

          (2002)
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            KDIGO clinical practice guideline for the care of kidney transplant recipients.

            (2009)
            The 2009 Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline on the monitoring, management, and treatment of kidney transplant recipients is intended to assist the practitioner caring for adults and children after kidney transplantation. The guideline development process followed an evidence-based approach, and management recommendations are based on systematic reviews of relevant treatment trials. Critical appraisal of the quality of the evidence and the strength of recommendations followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach. The guideline makes recommendations for immunosuppression, graft monitoring, as well as prevention and treatment of infection, cardiovascular disease, malignancy, and other complications that are common in kidney transplant recipients, including hematological and bone disorders. Limitations of the evidence, especially on the lack of definitive clinical outcome trials, are discussed and suggestions are provided for future research.
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              Chronic kidney disease.

              Chronic kidney disease is a general term for heterogeneous disorders affecting kidney structure and function. The 2002 guidelines for definition and classification of this disease represented an important shift towards its recognition as a worldwide public health problem that should be managed in its early stages by general internists. Disease and management are classified according to stages of disease severity, which are assessed from glomerular filtration rate (GFR) and albuminuria, and clinical diagnosis (cause and pathology). Chronic kidney disease can be detected with routine laboratory tests, and some treatments can prevent development and slow disease progression, reduce complications of decreased GFR and risk of cardiovascular disease, and improve survival and quality of life. In this Seminar we discuss disease burden, recommendations for assessment and management, and future challenges. We emphasise clinical practice guidelines, clinical trials, and areas of uncertainty. Copyright © 2012 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Int J Mol Sci
                Int J Mol Sci
                ijms
                International Journal of Molecular Sciences
                MDPI
                1422-0067
                22 December 2020
                January 2021
                : 22
                : 1
                : 43
                Affiliations
                [1 ]UCIBIO\REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; irina.filipa@ 123456hotmail.com (I.L.); luisbelo@ 123456ff.up.pt (L.B.)
                [2 ]Institute of Pharmacology & Experimental Therapeutics, & Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; freis@ 123456fmed.uc.pt
                [3 ]Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-504 Coimbra, Portugal
                [4 ]Clinical Academic Center of Coimbra (CACC), 3000-075 Coimbra, Portugal
                [5 ]Universitary Hospital Centre of Porto (CHUP), 4099-001 Porto, Portugal; diretora.depg@ 123456chporto.min-saude.pt
                [6 ]Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, 4050-313 Porto, Portugal
                [7 ]Nephrology Department, Coimbra University Hospital Center, 3004-561 Coimbra, Portugal; ruimbalves@ 123456hotmail.com
                [8 ]University Clinic of Nephrology, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
                Author notes
                [* ]Correspondence: assilva@ 123456ff.up.pt ; Tel.: +351-220-428-563
                Author information
                https://orcid.org/0000-0003-3401-9554
                https://orcid.org/0000-0003-3922-3618
                Article
                ijms-22-00043
                10.3390/ijms22010043
                7793089
                33375198
                d585ae7b-40e7-4701-9ea0-e321fb0144f1
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 30 November 2020
                : 21 December 2020
                Categories
                Review

                Molecular biology
                chronic kidney disease (ckd),tubular lesions,endothelial dysfunction,oxidative stress,metabolomic

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