Progress in Uremic Toxin Research: Genetics/Genomics in Chronic Kidney Disease—Towards Personalized Medicine?
Article first published online: 24 AUG 2009
© 2009 Wiley Periodicals, Inc.
Seminars in Dialysis
Volume 22, Issue 4, pages 417–422, July/August 2009
How to Cite
Luttropp, K., Lindholm, B., Carrero, J. J., Glorieux, G., Schepers, E., Vanholder, R., Schalling, M., Stenvinkel, P. and Nordfors, L. (2009), Progress in Uremic Toxin Research: Genetics/Genomics in Chronic Kidney Disease—Towards Personalized Medicine?. Seminars in Dialysis, 22: 417–422. doi: 10.1111/j.1525-139X.2009.00592.x
- Issue published online: 24 AUG 2009
- Article first published online: 24 AUG 2009
The progression rate of chronic kidney disease (CKD) to its terminal stage, end-stage renal disease (ESRD), and the development and severity of various complications, are at least indirectly influenced by genetic—and epigenetic—factors. For years, scientists have held out hope that the rapidly evolving field of genetics could transform medical diagnosis and treatment, moving beyond a trial-and-error approach towards “personalized medicine.” Indeed, there are now signs that the role of genetics and the pursuit of “personalized medicine” in medical care will be a priority for governments during years to come. But the vision of individualized treatment based on a patient’s genetic makeup and other biological markers has yet to materialize in the field of CKD and ESRD. As the toxic uremic environment may render CKD patients more sensitive to the effects of genetic variants, it is likely that genetic factors could be of special importance in this high-risk population. Therefore, outcome in the CKD population may be improved by establishing individual genetic/epigenetic profiles, thus enabling physicians to design an individualized therapeutic strategy. Personalized medicine based on a more individualized therapy could be applied in, for example, pharmacotherapy (CYP genes), dialysis therapy, and nutritional and lifestyle modifications.