Related Experiment Video
Updated: Aug 9, 2026
08:50
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Urinary Dickkopf-3 as a biomarker for kidney-function decline: a systematic review and meta-analysis
Yiwei Shang1,2, Binqi Wang1,2, Yue Huang1,2
1Department of Nephrology, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou 310006, Zhejiang, P.R. China.
Summary
Higher urinary Dickkopf-3 (uDKK3) indicates kidney function decline and fibrosis. This tubular-stress biomarker shows promise for risk stratification in kidney disease, complementing existing measures like eGFR.
Area of Science:
- Nephrology
- Biomarker Discovery
- Tubulointerstitial Disease
Background:
- Urinary Dickkopf-3 (uDKK3) is a glycoprotein linked to tubular injury, Wnt signaling, and kidney remodeling.
- Human studies on uDKK3 involve chronic kidney disease (CKD), cardiorenal disease, and transplantation.
- Existing research shows variability in clinical endpoints and assay platforms for uDKK3.
Purpose of the Study:
- To systematically review and synthesize human studies on urinary Dickkopf-3 (uDKK3).
- To assess the association of uDKK3 with kidney function decline, kidney failure, fibrosis, and transplant outcomes.
- To explore the impact of different assay platforms on uDKK3's clinical utility.
Main Methods:
- Comprehensive literature search of PubMed, Embase, CENTRAL, ClinicalTrials.gov, and conference abstracts up to May 2026.
- Risk of bias assessment using QUIPS.
- Meta-analysis of kidney function decline (HR/OR) and fibrosis correlation (Fisher-z), with random-effects models and assay-aware sensitivity analyses.
Main Results:
- Higher uDKK3 levels were consistently associated with kidney function decline or progression (pooled HR/OR composite 1.82).
- A fibrosis-enriched signal was observed in biopsy cohorts (pooled r=0.62), though imprecise.
- Assay-stratified analyses showed positive trends, with overlapping confidence intervals across different platforms.
Conclusions:
- Urinary Dickkopf-3 (uDKK3) is a robust biomarker for kidney function decline and shows a fibrosis-enriched signal.
- uDKK3 can serve as a complementary biomarker for risk stratification in kidney disease, alongside eGFR and albuminuria.
- Further research is needed for assay harmonization, validation, and prospective utility testing.
Related Concept Videos
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
01:25Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
01:24Serum Studies: Renal Function Tests
Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
01:17Factors Affecting Renal Clearance: Renal Impairment
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:28Diabetic Nephropathy
Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...