THE MECHANISMS OF PROTEINURIA AND ITS SIGNIFICANCE AS AN OUTCOME INDICATOR IN CHRONIC KIDNEY DISEASE
Ключевые слова:
biomarker, cardiovascular, chronic kidney disease, proteinuria.Аннотация
Chronic kidney diseases (CKD) share common pathological mechanisms that, regardless of the initial cause, lead to glomerular hyperfiltration, proteinuria, progressive renal scarring, and loss of kidney function. Substantial experimental evidence highlights the pivotal role of proteinuria in accelerating CKD progression to end-stage renal failure through various pathways, including the induction of tubular chemokine expression and complement activation. These processes trigger interstitial inflammatory cell infiltration and persistent fibrogenesis. Proteinuria is widely acknowledged as a key marker of CKD severity and a predictor of future declines in glomerular filtration rate. Furthermore, reducing proteinuria consistently correlates with slower renal function decline in both diabetic and non-diabetic kidney disease. Emerging data also reveal a link between proteinuria levels and cardiovascular risk, extending even to levels of urinary albumin excretion previously considered within the 'normal' range. Thus, proteinuria serves as a valuable surrogate endpoint in clinical trials for CKD and an important therapeutic target for reno- and cardioprotective strategies.
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