title: Biomarkers in chronic kidney disease: a review.
abstract: Chronic kidney disease (CKD) is a major public health problem. The classification of CKD by KDOQI and KDIGO and the routine eGFR reporting have resulted in increased identification of CKD. It is important to be able to identify those at high risk of CKD progression and its associated cardiovascular disease (CVD). Proteinuria is the most sensitive marker of CKD progression in clinical practice, especially when combined with eGFR, but these have limitations. Hence, early, more sensitive, biomarkers are required. Recently, promising biomarkers have been identified for CKD progression and its associated CVD morbidity and mortality. These may be more sensitive biomarkers of kidney function, the underlying pathophysiological processes, and/or cardiovascular risk. Although there are some common pathways to CKD progression, there are many primary causes, each with its own specific pathophysiological mechanism. Hence, a panel measuring multiple biomarkers including disease-specific biomarkers may be required. Large, longitudinal observational studies are needed to validate candidate biomarkers in a broad range of populations prior to implementation into routine CKD management. Recent renal biomarkers discovered include neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, and liver-type fatty acid-binding protein. Although none are ready for use in clinical practice, it is timely to review the role of such biomarkers in predicting CKD progression and/or CVD risk in CKD.
authors.affiliation: Renal Research, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. r.fassett@uq.edu.au
authors.forename: Robert G
authors.initials: RG
authors.lastname: Fassett
authors.forename: Sree K
authors.initials: SK
authors.lastname: Venuthurupalli
authors.forename: Glenda C
authors.initials: GC
authors.lastname: Gobe
authors.forename: Jeff S
authors.initials: JS
authors.lastname: Coombes
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Cooper
authors.forename: Wendy E
authors.initials: WE
authors.lastname: Hoy
mesh_terms: D000118:Acetylglucosaminidase / Q000032:analysis; D000209:Acute-Phase Proteins / Q000032:analysis; D015415:Biomarkers / Q000032:analysis*; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000209:etiology; D002908:Chronic Disease; D055316:Cystatin C / Q000097:blood; D018450:Disease Progression; D050556:Fatty Acid-Binding Proteins / Q000032:analysis; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000032:analysis; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D019746:Intramolecular Oxidoreductases / Q000097:blood; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000032:analysis / Q000097:blood; D008562:Membrane Glycoproteins / Q000032:analysis; D018384:Oxidative Stress; D011507:Proteinuria / Q000175:diagnosis; D011518:Proto-Oncogene Proteins / Q000032:analysis; D011991:Receptors, Virus / Q000032:analysis; D014527:Uric Acid / Q000097:blood
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D055316:Cystatin C; C493319:FABP1 protein, human; D050556:Fatty Acid-Binding Proteins; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus; D014527:Uric Acid; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D002097:C-Reactive Protein; D000118:Acetylglucosaminidase; D019746:Intramolecular Oxidoreductases; C022466:prostaglandin R2 D-isomerase