ABSTRACT

Chronic diseases constitute about 50% of the total disease burden in the general population, but carry about 80–90% of healthcare budgets in the Westernized world. Patients with mild renal dysfunction run an increased risk of the so-called end-organ failure and subsequently death. The classical cardiovascular risk profiling of patients at risk for cardiovascular and or renal disease is based on classical parameters derived from the Framingham study: age, sex, and modifiable factors such as blood pressure, cholesterol, body weight, diabetes, and smoking. Albuminuria has been associated with increased risk for end-organ damage. Interventions affecting the renin-angiotensin-aldosterone system have been associated with decrease in urinary albumin/protein excretion as well as with end-organ protection. The mechanism of the renal protection linked to albuminuria reduction remains unclear. It would be tempting to interpret the data implying that reduction of albuminuria results in less filtered and reabsorbed proteins, thus leading to less renal inflammation, interstitial fibrosis and functional decline.