Timed Urine Collections Are Not Needed to Measure Urine Protein Excretion in Clinical Practice

CHRONIC KIDNEY DISEASES (CKDs) requiring renal replacement therapy are increasing sharply worldwide and now are emerging as a major global health threat. 1 Xue J.L. Ma J.Z. Louis T.A. Collins A.J. Forecast of the number of patients with end-stage renal disease in the United States to the year 2010. J Am Soc Nephrol. 2001; 12: 2753-2758 PubMed Google Scholar If current trends in end-stage renal disease (ESRD) prevalence continue, the global ESRD population will exceed 2 million patients by 2010. 2 Lysaght M.J. Maintenance dialysis population dynamics Current trends and long-term implications. J Am Soc Nephrol. 2002; 13: S37-S40 PubMed Google Scholar Care of this group represents a major societal commitment: the aggregate cost of treating patients with ESRD during the coming decade will exceed $1 trillion. 2 Lysaght M.J. Maintenance dialysis population dynamics Current trends and long-term implications. J Am Soc Nephrol. 2002; 13: S37-S40 PubMed Google Scholar The number of those with CKD not yet in need of renal replacement therapy is much greater; however, data on the prevalence of predialysis CKD are available only as an estimation, at best. 3 Remuzzi G. Weening J.J. Albuminuria as early test for vascular disease. Lancet. 2005; 365: 556-557 Abstract Full Text Full Text PDF PubMed Google Scholar A sizeable proportion of these people will experience progression of their disease to ESRD. It increasingly is recognized that the burden of CKD is not limited to its implication on demand for renal replacement therapy, but that it has a major impact on overall population health. Patients with chronic renal dysfunction are at even greater risk for cardiovascular disease. 4 Collins A.J. Li S. Gilbertson D.T. Liu J. Chen S.C. Herzog C.A. Chronic kidney disease and cardiovascular disease in the Medicare population. Kidney Int Suppl. 2003; 87: S24-S31 Crossref PubMed Scopus (280) Google Scholar