Current opinion in nephrology and hypertension
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Curr. Opin. Nephrol. Hypertens. · May 2008
ReviewSalt intake, blood pressure and clinical outcomes.
Salt intake has long been known to influence blood pressure among hypertensive patients, but its effect among those without overt hypertension, as well as its effects on cardiovascular disease itself, have been disputed. This report reviews the evidence for an effect on both blood pressure and cardiovascular disease, particularly among normotensive participants, including recent data from randomized trials. ⋯ Average sodium consumption in the US population is excessively high, and well above recommended limits. Because most sodium derives from processed and restaurant foods, a reduction of sodium in these sources, as recently called for by the American Medical Association, is necessary to reduce exposure.
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The paucity of early, predictive, noninvasive biomarkers has impaired our ability to institute potentially effective therapies for acute kidney injury and chronic kidney disease in a timely manner. ⋯ The tools of functional genomics and proteomics have provided us with promising novel biomarkers for acute kidney injury and chronic kidney disease. It will be important in future studies to validate the sensitivity and specificity of these biomarker panels in clinical samples from large cohorts and in multiple clinical situations. Such studies will be facilitated by the availability of commercial tools for reproducible measurement of these panels.
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Curr. Opin. Nephrol. Hypertens. · May 2007
ReviewThe incidence and prognostic significance of acute kidney injury.
Acute kidney injury is an increasingly common and potentially catastrophic complication in hospitalized patients. This review summarizes the major epidemiologic studies that have informed our understanding of the incidence and prognostic significance of acute kidney injury. ⋯ In light of the increasing incidence and prognostic significance of acute kidney injury, new strategies for prevention and treatment are desperately needed.
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Curr. Opin. Nephrol. Hypertens. · May 2007
ReviewUnderstanding estimated glomerular filtration rate: implications for identifying chronic kidney disease.
Glomerular filtration rate (GFR) can be estimated using serum markers such as serum creatinine (SCr) or cystatin C. This review presents new insights into estimated GFR based on theory, validation studies, SCr assay standardization, cystatin C, and longitudinal comparison with measured GFR. ⋯ As a screening test, SCr should be interpreted as a marker of CKD probability in the context of the patient's clinical presentation. Measured GFR or creatinine clearance may be helpful in high-risk patients with normal SCr levels. GFR estimating equations should be reserved for patients with identified CKD. Standardized SCr and cystatin C assays are needed.