Department of Zoology, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka.
Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Int J Environ Res Public Health. 2020 Dec 18;17(24):9522. doi: 10.3390/ijerph17249522.
Chronic Kidney Disease (CKD) is a globally prevalent non-communicable disease with significant mortality and morbidity. It is typically associated with diabetes and hypertension; however, over the last two decades, an emergence of CKD of unknown etiology (CKDu) has claimed thousands of lives in several tropical agricultural communities. CKDu is associated with gradual loss of renal function without initial symptoms until reaching complete kidney failure and eventually death. The most impacted are young adult males of lower socio-economic strata. Since the disease progression can be successfully attenuated through early detection, the development of superior screening and management measures is of utmost importance. In contrast to the conventional biomarkers, novel biomarkers with improved sensitivity and specificity are being discussed as promising tools for early diagnosis of the disease. This review summarizes emerging novel biomarkers used in assessing CKD and discusses the current utility and diagnostic potential of such biomarkers for CKDu screening in clinical settings of different communities impacted by CKDu. Our goal is to provide a framework for practitioners in CKDu impacted regions to consider the use of these novel biomarkers through this synthesis. The increased use of these biomarkers will not only help to validate their diagnostic power further and establish potential prognostic value but may also provide critical insights into sites and mechanisms of renal damage.
慢性肾脏病（CKD）是一种在全球范围内普遍存在的非传染性疾病，具有较高的死亡率和发病率。它通常与糖尿病和高血压有关；然而，在过去的二十年中，一种病因不明的慢性肾脏病（CKDu）在几个热带农业社区中已经夺走了数千人的生命。CKDu 与肾功能逐渐丧失有关，在出现完全肾衰竭和最终死亡之前没有初始症状。受影响最严重的是社会经济地位较低的年轻成年男性。由于早期发现可以成功减轻疾病的进展，因此开发更好的筛查和管理措施至关重要。与传统的生物标志物相比，新型生物标志物具有更高的敏感性和特异性，被认为是早期诊断该疾病的有前途的工具。这篇综述总结了用于评估 CKD 的新兴新型生物标志物，并讨论了这些生物标志物在不同受 CKDu 影响社区的临床环境中进行 CKDu 筛查的当前实用性和诊断潜力。我们的目标是通过这篇综述为受 CKDu 影响地区的从业者提供一个考虑使用这些新型生物标志物的框架。这些生物标志物的使用增加不仅有助于进一步验证它们的诊断能力并建立潜在的预后价值，还可能为肾脏损伤的部位和机制提供重要的见解。
