Proteinuric Biomarkers in Chronic Kidney Disease

Risk stratification of patients with chronic kidney disease is crucial for early identification of patients at risk of disease progression and for timely initiation of treatments to prevent progression and the associated cardiovascular morbidity and mortality. Proteinuria and its components have been widely used for diagnosis and staging system of chronic kidney diseases. Albuminuria is used for diagnosis of kidney disease in the general population and kidney involvement in systemic diseases such as diabetes. However, albuminuria is not the most powerful predictor of disease outcome, and the urinary excretion of proteins larger than albumin such as IgM and IgG shows a higher predictive value: IgM-uria could be helpful for kidney and cardiovascular risk assessment of diabetic patients, and IgG-uria could be helpful for risk assessment of glomerulonephritis patients. This chapter presents a concise review of the clinical value of proteinuria profile for prediction of functional outcome and responsiveness to treatments in patients with chronic kidney disease.