Diagnosis of AKI and CKD relies on biomarkers that assess kidney function, these biomarkers are also essential for evaluation of the disease and treatment.
Biomarkers are substances that can be objectively measured and analyzed to determine whether the function of a patient’s kidney is healthy or abnormal, they can also be used to evaluate pathogenic processes or pharmacological responses to therapeutic interventions. For this reason, they are essential to the diagnosis and prognosis of AKI and CKD.
Biomarkers can be proteins, lipids, microRNAs, genes, metabolites, proteomic patterns, or cells present on a urinalysis. In CKD specifically, biomarkers usually are those that can be used to determine the glomerular filtration rate (GFR) of the kidney, a fall in which represents a decrease in kidney function. Measurement of GFR is necessary for a diagnosis of CKD, as well as for monitoring the disease and calculating drug dosage.
To determine GFR, blood urea nitrogen (BUN), serum creatinine (SCr), urinary albumin/protein and volume excretion are relied on as key biomarkers.
However, these well-established biomarkers have their limitations, for example, analysis of sCr or BUN is unable to discriminate between hemodynamic changes in the kidney that lead to appropriate changes in glomerular filtration rate (GFR) and rates that have been influenced by injury. Also, SCr is prone to error in certain situations, such as when patients have a low muscle mass or have a fluid overload.
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