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Updated: Aug 7, 2026

Assessment of Kidney Function in Mouse Models of Glomerular Disease
09:16

Assessment of Kidney Function in Mouse Models of Glomerular Disease

Published on: June 30, 2018

CKD screening: urinary albumin or uDKK3 or both?

Stefan Neuhaus1, Danilo Fliser1, Stefan Schunk1

  • 1Saarland University Medical Center, Clinic for Internal Medicine IV, Homburg/Saar, Germany.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|August 5, 2026
PubMed

Insights

Chronic kidney disease (CKD) affects millions, but early detection is challenging. A new urine biomarker, urinary Dickkopf-3 (uDKK3), aids in identifying progressive kidney damage, especially in non-albuminuric cases.

Area of Science:

  • Nephrology
  • Biomarker Discovery
  • Chronic Kidney Disease Pathophysiology

Background:

  • Chronic kidney diseases (CKD) impact 750 million globally, leading to significant morbidity and mortality.
  • Current CKD diagnosis using estimated glomerular filtration rate (eGFR) and albuminuria primarily detects glomerular injury, often missing progressive tubulointerstitial damage.
  • Non-albuminuric CKD, driven by tubulointerstitial injury, presents a diagnostic challenge for early identification of kidney function decline.

Purpose of the Study:

  • To evaluate urinary Dickkopf-3 (uDKK3) as a novel biomarker for detecting and predicting progressive CKD.
  • To assess the utility of uDKK3 in identifying high-risk individuals, particularly those with non-albuminuric CKD.
  • To propose integrating uDKK3 with albuminuria for comprehensive CKD screening.

Main Methods:

  • Clinical studies involving diverse CKD etiologies in adult and pediatric populations.
  • Analysis of urinary Dickkopf-3 (uDKK3) levels as a marker of proximal tubular epithelial cell injury.
  • Statistical adjustment for established CKD risk markers, including albuminuria, to determine uDKK3's predictive value.

Main Results:

  • Elevated uDKK3 levels significantly improved the detection and prediction of progressive CKD across various etiologies.
  • uDKK3 identified high-risk individuals for kidney function decline in non-albuminuric populations, including those with type 2 diabetes, heart, and lung diseases.
  • Findings support distinct CKD progression pathways involving glomerular versus tubulointerstitial injury.

Conclusions:

  • Urinary Dickkopf-3 (uDKK3) is a promising biomarker for progressive CKD, complementing albuminuria screening.
  • Integrating uDKK3 into screening strategies can enhance early detection of kidney damage, particularly in non-albuminuric forms.
  • Complementary biomarkers reflecting distinct injury pathways are crucial for effective CKD management.

Keywords:
CKDDKK3albuminuriaeGFRprogression

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