Advances in the Progression and Prognosis Biomarkers of Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) is one of the increasingly serious public health concerns worldwide; the global burden of CKD is increasingly due to high morbidity and mortality. At present, there are three key problems in the clinical treatment and management of CKD. First, the current diagnostic indicators, such as proteinuria and serum creatinine, are greatly interfered by the physiological conditions of patients, and the changes in the indicator level are not synchronized with renal damage. Second, the established diagnosis of suspected CKD still depends on biopsy, which is not suitable for contraindication patients, is also traumatic, and is not sensitive to early progression. Finally, the prognosis of CKD is affected by many factors; hence, it is ineviatble to develop effective biomarkers to predict CKD prognosis and improve the prognosis through early intervention. Accurate progression monitoring and prognosis improvement of CKD are extremely significant for improving the clinical treatment and management of CKD and reducing the social burden. Therefore, biomarkers reported in recent years, which could play important roles in accurate progression monitoring and prognosis improvement of CKD, were concluded and highlighted in this review article that aims to provide a reference for both the construction of CKD precision therapy system and the pharmaceutical research and development.

Biomarkers of aging

“…For over 70 years, eGFR has remained the primary index for detection and monitoring renal function. However, it does not accurately reflect renal tubular and interstitial lesions (Ix and Shlipak, 2021), and is not sensitive enough for identifying early-stage injury (Yan et al, 2021). Therefore, researchers have been working to find more early, comprehensive, and non-invasive biomarkers to reflect the extent of tubulointerstitial fibrosis and the progression of renal dysfunction.…”

The controversy of klotho as a potential biomarker in chronic kidney disease

“…Additionally, it must be noted that an individual biomarker, for example, sKlotho, inherently has some limitations for accurate diagnosis and monitoring progression in CKD without the combination of a set of other biomarkers because a single indicator lacks sufficient performance and efficiency to reflect the complexity of the mechanisms underlying CKD pathogenesis and development. Due to the limitations, clinical predictive models incorporating Klotho and other traditional or novel indicators possibly have the greatest potential to evaluate the clinical utility of Klotho ( Manou et al, 2020 ; Yan et al, 2021 ). Therefore, to gain more information regarding this association, additional high-quality studies in these respects should be conducted, and only in this way can current disputes be addressed and specifically resolved in the future.…”

Diagnostic performances of tumor necrosis factor-alpha and type IV collagen for diabetic nephropathy in type 2 diabetic patients

“…There has been an important achievement in finding associated biomarkers in all aspects of diabetic nephropathy. Thus, there is now a focus on novel biomarkers that have higher sensitivity and specificity for earlier detection of DN and a more precise prediction of its progression to end stages (Gluhovschi et al, 2016;Uwaezuoke et al, 2017;Thipsawat, 2021;Yan et al, 2021). In the present study, the levels of candidate markers (TNF and type IV collagen) increased by P < 0.001 in DM-DKD than in DM patients.…”