C-reactive protein and albuminuria: independent risk markers of renal and cardiovascular disease

Cardiovascular diseases continue to be one of the leading causes of death in general population, despite preventive measures in health care. Among subjects with renal impairment, cardiovas-cular mortality is up to 30 times higher than in the general population. The detection of subjects who are at risk for cardiovascular disease or deterioration of renal function is warranted. A number of classical risk factors are usually advocated to be of value in cardiovascular and renal medicine namely blood pressure, cholesterol, smoking and blood glucose levels. The thesis concerns the role of C-reactive protein and albuminuria, two novel risk markers, in the prediction of cardiovascular and renal disease progression. It has been proposed that both markers reflect putative mechanisms of atherosclerotic disease (progression), namely inflammation and endothelial dysfunction. We show that C-reactive protein and albuminuria are two independent and highly predictive risk markers for renal and cardiovascular morbidity and mortality: independently of each other and of classical risk factors. Future studies should be directed towards primary prevention in subjects who are characterised by both elevated C-reactive protein and albuminuria levels.