Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)
Proteinuria has been established as a marker of kidney damage in experimental studies and clinicians consider an early reduction in albuminuria as indicative of a favorable response to treatment. Albuminuria is a sensitive marker of kidney disease progression in early stages of CKD and appears to be a cause of CKD progression in some disease. Our initial publication in the general CKD population did not provide sufficient evidence to establish its validity in all settings. Indeed in a subsequently publication in IgA nephropathy, we were able to demonstrate that there is strong association between treatment effects on change in albuminuria and treatment effects on the clinical endpoint. In a subsequent larger meta-analysis in the general CKD population, we were able to provide data that support a role for change in albuminuria as a surrogate endpoint for CKD progression, particularly in patients with higher baseline albuminuria and where there are large treatment effects.