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Urinary biomarkers in kidney disease.
Esra Canki1, Esther Kho2, Joost G J Hoenderop1
1Department of Medical BioSciences, Radboudumc, Nijmegen, The Netherlands.
Clinica Chimica Acta; International Journal of Clinical Chemistry
|January 27, 2024
Summary
Early detection of chronic kidney disease (CKD) is crucial. This review highlights promising urinary biomarkers, like KIM-1, for diagnosing and managing CKD, improving patient outcomes.
Area of Science:
- Nephrology
- Biomarker Discovery
- Analytical Chemistry
Background:
- Chronic kidney disease (CKD) is a global health concern with insufficient early detection methods.
- Urinary biomarkers offer a promising avenue for early CKD diagnosis and management.
- Advancements in analytical techniques enhance the potential of urinalysis for CKD assessment.
Purpose of the Study:
- To review evolving technologies in urinalysis for CKD detection.
- To identify key urinary biomarkers for diagnosing and managing CKD.
- To assess the utility of biomarkers in monitoring CKD progression and outcomes.
Main Methods:
- A systematic literature search was conducted using terms: CKD, biomarkers, and urine.
- The review encompassed 53 studies and evaluated 37 distinct urinary biomarkers.
- Biomarker value was assessed for CKD diagnosis, progression monitoring, mortality prediction, and nephrotoxicity evaluation.
Main Results:
- Kidney Injury Molecule-1 (KIM-1) showed strong diagnostic potential, increasing with incident CKD.
- Dickkopf-3 (DKK3) levels correlated with declining estimated glomerular filtration rate (eGFR).
- Uromodulin (UMOD) levels decreased with worsening kidney function; however, no single biomarker adequately assessed mortality or nephrotoxicity.
Conclusions:
- Emerging urinalysis technologies, including smart toilets, present new opportunities for biomarker detection.
- Several urinary biomarkers show potential for CKD diagnosis and management.
- Further research is needed to validate biomarkers for comprehensive CKD assessment, including mortality and nephrotoxicity.
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