Precision Nephrology Is a Non-Negligible State of Mind in Clinical Research
| Autor: | Silvio Borrelli, Michele Andreucci, Carlo Garofalo, Michelle J Pena, Laura Antolini, Ida Gagliardi, Giulia Capitoli, Luca De Nicola, Michele Provenzano |
|---|---|
| Přispěvatelé: | Provenzano, M., De Nicola, L., Pena, M. J., Capitoli, G., Garofalo, C., Borrelli, S., Gagliardi, I., Antolini, L., Andreucci, M., Provenzano, M, De Nicola, L, Pena, M, Capitoli, G, Garofalo, C, Borrelli, S, Gagliardi, I, Antolini, L, Andreucci, M |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Population 030232 urology & nephrology 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Risk Factors Chronic kidney disease Ckd medicine Albuminuria Humans Precision Medicine Renal Insufficiency Chronic Risk factor Intensive care medicine education education.field_of_study ESKD business.industry End-stage kidney disease Cardiovascular risk Prognosis Cardiovascular disease Precision medicine Personalized medicine Clinical trial Proteinuria Treatment Outcome Clinical research Nephrology Cohort Disease Progression Risk score Observational study Precision nephrology business Glomerular Filtration Rate |
| Zdroj: | Nephron. 144(10):463-478 |
| ISSN: | 0028-2766 |
| Popis: | CKD is a major public health problem. It is characterized by a multitude of risk factors that, when aggregated, can strongly modify outcome. While major risk factors, namely, albuminuria and low estimated glomerular filtration rate (eGFR) have been well analyzed, a large variability in disease progression still remains. This happens because (1) the weight of each risk factor varies between populations (general population or CKD cohort), countries, and single individuals and (2) response to nephroprotective drugs is so heterogeneous that a non-negligible part of patients maintains a high cardiorenal risk despite optimal treatment. Precision nephrology aims at individualizing cardiorenal prognosis and therapy. The purpose of this review is to focus on the risk stratification in different areas, such as clinical practice, population research, and interventional trials, and to describe the strategies used in observational or experimental studies to afford individual-level evidence. The future of precision nephrology is also addressed. Observational studies can in fact provide more adequate findings by collecting more information on risk factors and building risk prediction models that can be applied to each individual in a reliable fashion. Similarly, new clinical trial designs can reduce the individual variability in response to treatment and improve individual outcomes. |
| Databáze: | OpenAIRE |
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