Clinical Proteomics in Kidney Disease: From Discovery to Clinical Application

Abstract

Proteome analysis has been applied in multiple studies in the context of chronic kidney disease, aiming at improving our knowledge on the molecular pathophysiology of the disease. The approach is generally based on the hypothesis that proteins are key in maintaining kidney function, and disease is a clinical consequence of a significant change of the protein level. Knowledge on critical proteins and their alteration in disease should in turn enable identification of ideal biomarkers that could guide patient management. In addition, all drugs currently employed target proteins. Hence, proteome analysis also promises to enable identifying the best suited therapeutic target, and, in combination with biomarkers, could be used as the rationale basis for personalized intervention. To assess the current status of proteome analysis in the context of CKD, we present the results of a systematic review, of up-to-date scientific research, and give an outlook on the developments that can be expected in near future. Based on the current literature, proteome analysis has already seen implementation in the management of CKD patients, and it is expected that this approach, also supported by the positive results generated to date, will see advanced high-throughput application.

Inflammation-Related Mechanisms in Chronic Kidney Disease Prediction, Progression, and Outcome

“…Unfortunately, current clinical approaches have become useful only in diagnosis of advanced CKD stages. Simply stated, once developed, CKD persists throughout the rest of the patient's life, and the single most feasible solution is likely linked to an early intervention, before irreversible nephron damage occurs [ 142 ]. In addition, nephrology lags behind other medical disciplines in terms of number, size, and quality of clinical trials undertaken, thus emerging provocative global action plans in order to improve the management of CKD and design novel therapeutic approaches to alleviate or even halt the progression of the disease [ 141 ].…”

Biomarkers in Progressive Chronic Kidney Disease. Still a Long Way to Go

“…Urinary proteomics have also been utilized in the pursuit of earlier detection and risk stratification of CKD patients. CKD273 is a classifier that represents the combination of 273 urine peptides measured by coupled-mass spectrometry and found to differ significantly between patients with CKD of different causes and normal controls in a study from 2010 [97,98]. CKD273 has since been validated in numerous studies.…”

Proteomic Approaches and Potential Applications in Autosomal Dominant Polycystic Kidney Disease and Fabry Disease

“…Blood and urine are accessible biofluids that are vital for current diagnostic and prognostic techniques in clinical nephrology. Perhaps most significantly however, is the fact that proteins are modifiable and can thus be targeted for treatment follow-up [ 17 , 18 ].…”