Urinary biomarkers: recommendations of the Joint European/United States Workshop for future research

The session concluded on a positive note with enthusiasm on the part of participates to become involved in one of the proposed joint protocols. Left to be answered was whether or not individual urinary biomarkers can be tailored to be disease specific or will there always be a need for a panel of biomarkers to insure interpretable results? It was agreed that proposals for three studies would be prepared. The first study will take advantage of the fact that field studies are currently being organized by both European and American groups. European scientists are working with the World Health Organization to investigate lead exposure in a region of China. At the same time, scientists in the United States are implementing a surveillance program in a population exposed to lead and other heavy metals in Kellogg, Idaho. These efforts provide an excellent opportunity for the sharing of samples and the study of a biomarkers panel that would contain both standard and candidate biomarkers. It was agreed that the parties interested in participating would alert the workshop organizers. The second study will expand upon a protocol developed by Dr. Debroe that has as its subjects non-transplant patients being treated with cyclosporine. An additional complimentary study of tacrolimus (FK-506) nephrotoxicity will also be developed. This protocol will be designed to follow the loss of renal function with a urinary biomarkers panel. The third study will follow the lead of Dr. Safirstein who urged the consideration of Cisplatin nephrotoxicity as a singular model for analyzing the usefulness of various biomarkers as measures of both acute and chronic nephrotoxicity.