Department of Medical BioSciences, Radboudumc, Nijmegen, The Netherlands.
imec within OnePlanet Research Center, Wageningen, The Netherlands.
Clin Chim Acta. 2024 Mar 1;555:117798. doi: 10.1016/j.cca.2024.117798. Epub 2024 Jan 26.
Chronic kidney disease (CKD) affects many people worldwide and early diagnosis is essential for successful treatment and improved outcome. Unfortunately, current methods are insufficient especially for early disease detection. However, advances in the analytical methods for urinary biomarkers may provide a unique opportunity for diagnosis and management of CKD. This review explores evolving technology and highlights the importance of early marker detection in these patients.
A search strategy was set up using the terms CKD, biomarkers, and urine. The search included 53 studies comprising 37 biomarkers. The value of these biomarkers for CKD are based on their ability to diagnose CKD, monitor progression, assess mortality and nephrotoxicity.
KIM-1 was the best marker for diagnosis as it increased with the development of incident CKD. DKK3 increased in patients with declining eGFR, whereas UMOD decreased in those with declining kidney function. Unfortunately, none fulfilled all criteria to adequately assess mortality and nephrotoxicity.
New developments in the field of urinalysis using smart toilets may open several possibilities for urinary biomarkers. This review explored which biomarkers could be used for CKD disease detection and management.
慢性肾病（CKD）影响着全球许多人，早期诊断对于成功治疗和改善预后至关重要。不幸的是，目前的方法还不够完善，尤其是在早期疾病检测方面。然而，尿液生物标志物分析方法的进步可能为 CKD 的诊断和管理提供独特的机会。本综述探讨了不断发展的技术，并强调了早期标志物检测在这些患者中的重要性。
使用 CKD、生物标志物和尿液等术语制定了搜索策略。该搜索包括 53 项研究，共包含 37 个生物标志物。这些生物标志物在 CKD 中的价值基于它们诊断 CKD、监测进展、评估死亡率和肾毒性的能力。
Kim-1 是诊断 CKD 的最佳标志物，因为它随着新发 CKD 的发展而增加。DKK3 在 eGFR 下降的患者中增加，而 UMOD 在肾功能下降的患者中减少。不幸的是，没有一个标志物能够充分满足评估死亡率和肾毒性的所有标准。
使用智能马桶进行尿液分析的新进展可能为尿液生物标志物开辟多种可能性。本综述探讨了哪些生物标志物可用于 CKD 疾病的检测和管理。
