Are biomarkers useful for assessing cardiovascular risk in patients with chronic kidney disease?
OBJECTIVE
Chronic kidney disease is now recognized as an independent risk factor for cardiovascular events, and cardiovascular disease is the major cause of mortality in patients with the disease. Recent studies have attempted to evaluate the utility of biomarkers for assessing cardiovascular risk in patients with chronic kidney disease. This review will summarize these studies and critically assess the utility of cardiovascular risk biomarkers for clinical practice.


RESULTS
Traditional cardiovascular risk factors including dyslipidemia, hypertension, smoking and diabetes mellitus are highly prevalent in patients with chronic kidney disease. Although prediction models using traditional risk factors underestimate cardiovascular disease risk in these patients, nontraditional biomarkers (i.e. markers of inflammation, endothelial dysfunction, myocardial necrosis, and left ventricular remodeling) have been associated with increased cardiovascular event rates and mortality risk in populations with and without chronic kidney disease. Moreover, a high prevalence of biomarkers that are directly attributable to loss of kidney function is observed in patients with the disease.


CONCLUSIONS
Recent studies suggest only limited utility of either single or multiple biomarkers of cardiovascular risk as prognostic tools in patients with and without chronic kidney disease. Novel approaches for biomarker development capturing augmented information through a systems biology approach are urgently needed to improve the usefulness of cardiovascular risk biomarkers.
Rubin
Clifford
C
Division of Nephrology and Transplantation, Department of Medicine, Maine Medical Center, Portland, Maine 04102, USA.
Nolin
Thomas D
TD
Himmelfarb
Jonathan
J
D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors
D015415:Biomarkers