Abramowitz et al. report that the albumin-adjusted and full anion gaps are independent predictors of all-cause mortality after adjusting for estimated glomerular filtration rate (eGFR). This finding raises the question as to whether subtle changes in tubular function could identify patients at increased risk of adverse outcomes, even in those with eGFR >60 ml/min/1.73 m2.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Abramowitz, M. K., Hostetter, T. H. & Melamed, M. L. The serum anion gap is altered in early kidney disease and associates with mortality. Kidney Int. http://dx.doi.org/10.1038/ki.2012.196.
Levey, A. S. et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 80, 17–28 (2011).
Gansevoort, R. T. et al. Lower estimated GFR and higher albuminuria are associated with adverse kidney outcomes. A collaborative meta-analysis of general and high-risk population cohorts. Kidney Int. 80, 93–104 (2011).
El Nahas, M. Cardio-kidney-damage: a unifying concept. Kidney Int. 78, 14–18 (2010).
Nangaku, M. Chronic hypoxia and tubulointerstitial injury: a final common pathway to end-stage renal failure. J. Am. Soc. Nephrol. 17, 17–25 (2006).
Raphael, K. L., Wei, G., Baird, B. C., Greene, T. & Beddhu, S. Higher serum bicarbonate levels within the normal range are associated with better survival and renal outcomes in African Americans. Kidney Int. 79, 356–362 (2011).
Kamijo, A. et al. Urinary fatty acid-binding protein as a new clinical marker of the progression of chronic renal disease. J. Lab. Clin. Med. 143, 23–30 (2004).
Bazzi, C. et al. Urinary N-acetyl-β-glucosaminidase excretion is a marker of tubular cell dysfunction and a predictor of outcome in primary glomerulonephritis. Nephrol. Dial. Transplant. 17, 1890–1896 (2002).
Bolignano, D. et al. Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease. Clin. J. Am. Soc. Nephrol. 4, 337–344 (2009).
van Timmeren, M. M. et al. High urinary excretion of kidney injury molecule-1 is an independent predictor of graft loss in renal transplant recipients. Transplantation 84, 1625–1630 (2007).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Jain, N., Reilly, R. Filling in the gap. Nat Rev Nephrol 8, 562–563 (2012). https://doi.org/10.1038/nrneph.2012.188
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrneph.2012.188
This article is cited by
-
Effects of dietary interventions on incidence and progression of CKD
Nature Reviews Nephrology (2014)
