School of Biomedical Engineering, The University of New South Wales, Sydney, NSW, Australia.
Macquarie Medical School, Faculty of Medicine, Health & Human Sciences, Macquarie University, NSW, Australia.
J Physiol. 2023 Jul;601(14):2801-2826. doi: 10.1113/JP284289. Epub 2023 Jun 8.
Renal fibrosis is the final common pathophysiological pathway in chronic kidney disease (CKD) regardless of the underlying cause of kidney injury. Tubulointerstitial fibrosis (TIF) is considered to be the key pathological predictor of CKD progression. Currently, the gold-standard tool to identify TIF is kidney biopsy, an invasive method that carries risks. Non-invasive diagnostics rely on an estimation of glomerular filtration rate and albuminuria to assess kidney function, but these fail to diagnose early CKD accurately or to predict progressive decline in kidney function. In this review, we summarize the current and emerging molecular biomarkers that have been studied in various clinical settings and in animal models of kidney disease and that are correlated with the degree of TIF. We examine the potential of these biomarkers to diagnose TIF non-invasively and to predict disease progression. We also examine the potential of new technologies and non-invasive diagnostic approaches in assessing TIF. Limitations of current and potential biomarkers are discussed and knowledge gaps identified.
肾纤维化是慢性肾脏病（CKD）的最终共同病理生理途径，无论肾脏损伤的潜在原因如何。肾小管间质纤维化（TIF）被认为是 CKD 进展的关键病理预测因子。目前，识别 TIF 的金标准工具是肾活检，这是一种有风险的侵入性方法。非侵入性诊断依赖于肾小球滤过率和蛋白尿的估计来评估肾功能，但这些方法无法准确诊断早期 CKD 或预测肾功能进行性下降。在这篇综述中，我们总结了目前和新兴的分子生物标志物，这些标志物已在各种临床环境和肾脏病动物模型中进行了研究，并与 TIF 的程度相关。我们研究了这些生物标志物在 TIF 非侵入性诊断和疾病进展预测方面的潜力。我们还研究了新技术和非侵入性诊断方法在评估 TIF 方面的潜力。讨论了当前和潜在生物标志物的局限性，并确定了知识空白。
