ReviewClinical journal of the American Society of Nephrology : CJASN2015
Albuminuria is Not an Appropriate Therapeutic Target in Patients with CKD: The Con View.
Review in Clinical journal of the American Society of Nephrology : CJASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Guidelines for clinical evaluation of chronic kidney disease in early stages : AMED research on regulatory science of pharmaceuticals and medical devices.Clinical and experimental nephrology · 2024Guideline
- Change in albuminuria and subsequent risk of end-stage kidney disease: an individual participant-level consortium meta-analysis of observational studies.The lancet. Diabetes & endocrinology · 2019Pooled it
- Guidelines for clinical evaluation of chronic kidney disease : AMED research on regulatory science of pharmaceuticals and medical devices.Clinical and experimental nephrology · 2018Guideline
- Extracellular vesicles play a central role in linking podocyte injury to mesangial activation in glomerular disease.Theranostics · 2025Article
- Long-term outcomes of add-on direct renin inhibition in igA nephropathy: a propensity score-matched cohort study.Journal of nephrology · 2023Article
- The association between serum activin A levels and albuminuria among community-dwelling middle-aged and older adults in Taiwan.Scientific reports · 2021Article
- Kidney disease trials for the 21st century: innovations in design and conduct.Nature reviews. Nephrology · 2020Review
- Not all proteinuria is created equal.The Journal of clinical investigation · 2020Article
- Combination of Changes in Estimated GFR and Albuminuria and the Risk of Major Clinical Outcomes.Clinical journal of the American Society of Nephrology : CJASN · 2019Observational
- Albuminuria: a target for clinical trials in kidney disease?Nature reviews. Nephrology · 2019Article
- Role of albumin and its modifications in glomerular injury.Pflugers Archiv : European journal of physiology · 2017Review
- Low Sodium Diet, Vitamin D, or Both for RAASi-Resistant, Residual, Proteinuria in CKD? The ViRTUE Trial Points the Way Forward but Is Not the Last Word.Journal of the American Society of Nephrology : JASN · 2017Article
- The Tubulointerstitial Pathophysiology of Progressive Kidney Disease.Advances in chronic kidney disease · 2017Review
- Diet and Diabetic Kidney Disease: Plant Versus Animal Protein.Current diabetes reports · 2017Review
- Albuminuria changes are associated with subsequent risk of end-stage renal disease and mortality.Kidney international · 2017Observational
- Developing Treatments for Chronic Kidney Disease in the 21st Century.Seminars in nephrology · 2016Review
- Renal Protective Effect of DPP-4 Inhibitors in Type 2 Diabetes Mellitus Patients: A Cohort Study.Journal of diabetes research · 2016Observational
- Improvements in the Management of Diabetic Nephropathy.The review of diabetic studies : RDSReview
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Albuminuria is a risk factor for progression of kidney disease. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers slow the progression to ESRD, an effect that is correlated with reduction in albuminuria. This has led to the hypothesis that albuminuria should be a target for therapy. This work argues that there are issues with this hypothesis. The previously reported studies were not designed to test the hypothesis that achieving a specific albuminuria target would be beneficial in and of itself irrespective the mechanism used to achieve that goal. One cannot assume that the beneficial effect observed was causally related to the effect on albuminuria or that it would extend to other interventions. Most importantly, it is not known if the approach of maximizing therapy to reduce proteinuria is safe. Recent studies have shown that combining renin-angiotensin system therapies decreases albuminuria without significant clinical benefit but with increased risk of adverse events. More studies are needed, but at this time, albuminuria has not jumped the hurdle needed to be accepted as a surrogate end point or target for treatment. Primum non nocere, first do no harm.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.