Chronic kidney disease (CKD) is a major global health problem. Unless intensive intervention is initiated, some patients can rapidly progress to end-stage kidney disease. However, it is often difficult to predict renal outcomes using conventional laboratory tests in individuals with CKD. Therefore, many researchers have been searching for novel biomarkers to predict the progression of CKD

Chronic kidney disease (CKD) is now one of the most important global health problems. Increased prevalence of hypertension, diabetes mellitus and obesity has led to a pandemic of CKD in both the developed and the developing countries.

Early detection and interventions including underlining disease-specific therapies, as well as blood pressure control and lifestyle modification, can successfully slow the progression of CKD. However, the CKD population is extremely heterogeneous. Some CKD patients maintain their renal function over a few decades, whereas others experience a loss of function within a few years.

Since it is often difficult to predict whether a CKD patient has the higher risk for end-stage kidney disease (ESKD) with conventional laboratory tests, many investigators are searching for novel biomarkers for the progression of CKD.

Angiogenesis is involved in physiological and pathological processes in the kidney and is regulated by the balance between a proangiogenic factor, vascular endothelial growth factor (VEGF)-A, and various endogenous antiangiogenic factors.

Antiangiogenic factors in the pathogenesis of CKD

In recent reports using genetically engineered mice, the roles of these antiangiogenic factors in the pathogenesis of kidney disease have become increasingly clear. In addition, recent clinical studies have demonstrated associations between circulating levels of antiangiogenic factors and renal dysfunction in CKD patients.

In this review, we summarize recent advances in the study of representative endogenous antiangiogenic factors, including soluble fms-related tyrosine kinase 1, soluble endoglin, pigment epithelium-derived factor, VEGF-A165b, endostatin, and vasohibin-1, in associations with kidney diseases and discuss their predictive potentials as biomarkers of progression of CKD.

Recent evidence has demonstrated the involvement of various antiangiogenic factors in the pathogenesis of kidney diseases. Furthermore, many clinical studies have disclosed the association between circulating and urinary levels of such antiangiogenic factors and renal dysfunction in CKD.

According to some therapeutic benefits in animal experiments, as discussed above, efforts to clarify the associations between antiangiogenic factors and the progression of CKD using clinical studies could lead to the development of novel CKD therapies targeting these factors