Biomarkers and Next Generation Sequencing in Chronic Kidney Disease
Biomarkers are becoming increasingly important for predicting disease prognosis
and enabling personalized therapy.
As we previously reviewed, biomarkers are increasingly being investigated for their
utility in predicting patients most at risk of decline in
renal function in order to rationalize and target care because of the escalating
cost of monitoring and follow-up required in the care of patients with CKD.
However, to date no reliable biomarker is available in clinical practice.
Current renal biomarkers include glomerular filtration rate measurement,
cardiovascular disease prediction, CKD progression, inflammatory and fibrotic markers.
The currently utilized biomarkers of CKD include estimated glomerular filtration rate,
albuminuria, cystatin C, nitric oxide, asymmetric dimethylarginine and neutrophil
gelatinase associated lipocalin, especially eGFR.
However, as the golden standard parameter, eGFR is based on creatinine levels,
which could be influenced by the metabolic variants. And those biomarkers are not
sensitive and specific enough for early stage CKD patients, which
results in the delayed intervention on CKD patients.
Besides, most of them can’t distinguish the risk of developing CKD and
estimate the kidney function accurately. Although, eGFR and
albuminuria are used to define CKD, however they do not accurately
indicate the renal function and injury in all forms of CKD.
For example, a proportion of patients with diabetic nephropathy
develop renal failure without proteinuria. Moreover in kidney transplantation,
the poor performance of biomarkers may lead to missing opportunity to receive potential kidneys
because of the inaccurate low eGFR of living donors.
In a word, current renal diagnosis and treatment situation requires more specific,
stable and precise biomarkers for CKD.
Nephrol Open J. 2016; 2(1): 23-25. doi: 10.17140/NPOJ-2-115