[Laboratory tests for kidney disease]

Area of Science:

• Nephrology
• Clinical Diagnostics

Background:

• Kidney diseases frequently present with poor prognoses due to late diagnosis.
• Current diagnostic guidelines rely on estimated glomerular filtration rate (eGFR) using creatinine and cystatin C, and urinary albumin excretion.
• These established markers have limitations, potentially causing diagnostic delays and prognostic misinterpretations.

Purpose of the Study:

• To highlight the limitations of current kidney disease diagnostic markers.
• To emphasize the need for novel biomarkers for sensitive and specific detection of kidney damage.
• To underscore the role of urinalysis in complementing laboratory diagnostics for kidney diseases.

Main Methods:

• Review of current Kidney Disease Improving Global Outcomes (KDIGO) guidelines.
• Analysis of limitations associated with functional markers (creatinine, cystatin C) and urinary albumin excretion.
• Evaluation of urinalysis as a complementary diagnostic tool.

Main Results:

• Current eGFR and albuminuria methods have interpretational challenges.
• Diagnostic delays and prognostic inaccuracies can result from existing marker limitations.
• Urinalysis offers valuable insights for screening, localization, and differentiation of kidney diseases.

Conclusions:

• There is a critical need for new kidney damage markers.
• Novel markers should offer improved sensitivity and specificity for early and accurate diagnosis.
• Urinalysis plays a vital role in the comprehensive diagnostic workup of renal and urinary tract conditions.