The worldwide incidence and prevalence of chronic kidney disease continue to soar. Global prevalence of chronic kidney disease has been estimated to be between 11% to 13% of the world population. The traditional and nontraditional risk factors in chronic kidney disease predispose the patients to high cardiovascular complications. The high occurrence of cardiovascular disease in chronic kidney disease patients requires careful assessment of possible risks, with the hope of mitigating the burden of the disease and its attendant consequences. Some of the numerous possibilities suggested for the wide distribution of cardiovascular disease in chronic kidney disease patients include: Ageing population, increasing prevalence of hypertension and type 2-diabetes, low detection rate, treatment inertia and reluctance in the early stages of chronic kidney disease. The risk factors for cardiovascular disease in chronic kidney disease patients have been broadly divided into traditional and nontraditional risk factors. These risk factors have synergistic effect and speeds up the process of atherosclerosis and evolution of chronic kidney disease. It is important to accurately evaluate these risk factors with the ultimate aim of reducing the disease burden and minimizing complications. 

The traditional risk factors for cardiovascular disease are risk factors for chronic kidney disease and are therefore common in chronic kidney disease patients. Examples include:  Increasing age, hypertension, dyslipidemia, diabetes, smoking and obesity. They contribute in no small measure to the initiation of cardiovascular disease in the early chronic kidney disease stages and in turn worsen chronic kidney disease progression.

 The non-traditional or ‘novel’ risk factors are ‘uremia specific’, or at least much more common in patients with chronic kidney disease than in the general population. These include albuminuria, anemia, hyperparathyroidism, metabolic bone disease, hyper homocysteinaemia, hyperuricemia malnutrition, apo lipoprotein isoforms, inflammation, endothelial dysfunction and oxidative stress.

Chronic kidney disease develops over a relatively long period of time with a significant asymptomatic period in between.  Hence the utility of biomarkers for early identification of the disease stage and its attendant consequences is necessary. The use of biomarkers however, has not been without criticisms.

Renal biomarkers of note include cystatin C and serum creatinine which have been used to assess and predict renal function. Other notable markers of renal function include urine albumin, uric acid, and microglobulin. Various novel biomarkers have also been suggested to improve risk assessment and early identification of kidney injury.

Albuminuria has been considered a prognostic marker for cardiovascular disease, with or without renal involvement. Higher levels of albuminuria indicate a graded increase in risk for mortality independent of estimated glomerular filteration rate. Low estimated glomerular filteration rate and higher albuminuria has been linked with cardiovascular disease. Hence there is need for regular assessment of albuminuria in chronic kidney disease patients.

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