Advances in the use of multimarker panels for renal risk stratification.

PURPOSE OF REVIEW: This review discusses novel studies in the past year that have examined the use of combinations of multiple markers to improve risk prediction in the setting of chronic kidney disease (CKD). We will focus on multimarker panels to: improve prediction of CKD onset; improve classification of CKD and risk stratification of persons with CKD; and develop individual-level risk scores for progression to end-stage renal disease (ESRD). RECENT
FINDINGS: One study reported that several novel circulation biomarkers may aid in predicting incident CKD and microalbuminuria. Second, our group has shown that the combination of creatinine, cystatin C, and albuminuria improves detection and risk stratification for death, heart failure, cardiovascular events, and ESRD compared with creatinine alone. Finally, a highly accurate individual risk score was developed to predict progression to ESRD using readily available clinical markers.
SUMMARY: The combination of multiple markers improves detection and risk stratification in CKD. Future research is needed in understanding the use of a 'renal panel' for detection, classification, and risk stratification in kidney disease in diverse populations. The studies presented here represent the beginning of a paradigm shift to multimarker panels in nephrology.