Madhvapathy Surabhi R, Cho Soongwon, Gessaroli Elisa, Forte Eleonora, Xiong Yirui, Gallon Lorenzo, Rogers John A
Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA.
Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.
Nat Rev Nephrol. 2025 Apr 29. doi: 10.1038/s41581-025-00961-2.
Established clinical practices for monitoring kidney health and disease - including biopsy and serum biomarker analysis - suffer from practical limitations in monitoring frequency and lack adequate sensitivity for early disease detection. Engineering advances in biosensors have led to the development of wearable and implantable systems for monitoring of kidney health. Non-invasive microfluidic systems have demonstrated utility in the detection of kidney-relevant biomarkers, such as creatinine, urea and electrolytes in peripheral body fluids such as sweat, interstitial fluid, tears and saliva. Implantable systems may aid the identification of early transplant rejection through analysis of organ temperature and perfusion, and enable real-time assessment of inflammation through the use of thermal sensors. These technologies enable continuous, real-time monitoring of kidney health, offering complementary information to standard clinical procedures to alert physicians of changes in kidney health for early intervention. In this Review, we explore devices for monitoring renal biomarkers in peripheral biofluids and discuss developments in implantable sensors for the direct measurement of the local, biophysical properties of kidney tissue. We also describe potential clinical applications, including monitoring of chronic kidney disease, acute kidney injury and allograft health.
用于监测肾脏健康和疾病的既定临床实践——包括活检和血清生物标志物分析——在监测频率方面存在实际限制，并且对疾病早期检测缺乏足够的敏感性。生物传感器的工程进展已促使可穿戴和可植入系统的开发，用于监测肾脏健康。非侵入性微流控系统已在检测与肾脏相关的生物标志物方面展现出实用性，例如在汗液、间质液、泪液和唾液等外周体液中检测肌酐、尿素和电解质。可植入系统可通过分析器官温度和灌注来辅助识别早期移植排斥反应，并通过使用热传感器实现对炎症的实时评估。这些技术能够对肾脏健康进行连续、实时监测，为标准临床程序提供补充信息，以提醒医生注意肾脏健康的变化以便早期干预。在本综述中，我们探讨用于监测外周生物流体中肾脏生物标志物的设备，并讨论用于直接测量肾脏组织局部生物物理特性的可植入传感器的进展。我们还描述了潜在的临床应用，包括对慢性肾脏病、急性肾损伤和同种异体移植物健康的监测。
