Background

Chronic Kidney Disease (CKD) is an increasing health problem with highly significant socioeconomic implications, affecting approx. 10 percent of the population:

  • The burden of morbidity and mortality associated with CKD derives fromprogression of CKD to end stage renal disease and
  • A disproportionate increase in the risk of cardiovascular disease (CVD) with an approx. 30-fold increase in CVD mortality.

However, the course of progression of CKD and CVD in the setting of CKD is highly variable and factors determining progression and complication rates are to a large extent unknown.

 

Elevated blood pressure and urinary loss of albumin are well known risk factors for kidney disease progression but they alone can not attribute to the extent of the variability in the loss of renal function. Neither can the traditional cardiovascular risk factors explain the elevated risk of patients with kidney disease for CVD, as they can in the general population.

The heterogeneity in kidney disease progression, the difficulties in defining homogenous subpopulations and the lack of surrogate markers to estimate the success of interventions largely explain why the numbers of randomized clinical trials in nephrology lags far behind those in all other medical disciplines.

As a consequence of the lack of knowledge about disease characteristics, progression and treatment effects, the care of CKD patients is likely to be refrained from deriving the benefits of medical progress. The GCKD-Study aims at transferring scientific insight into an individualized, targeted therapy.