Kidney Biomarkers

Since laboratory testing and biomarkers are an integral part in the diagnosis and treatment of kidney disease, Kidney Biomarkers: Clinical Aspects and Laboratory Determination covers currently used biomarkers as well as markers that are in development. Laboratories are increasingly more involved in the follow-up confirmatory laboratory testing and this unique volume showcases the collaboration needed to solve diagnostic clinical puzzles between the laboratory and clinician. This volume provides guidance on laboratory test selection and results interpretation in patients. Sources of inaccurate results in the measurement of kidney biomarkers are discussed along with possibility of eliminating such interferences. Each chapter is organized with a uniform easy-to-follow format with insightful case examples highlighting the collaboration between clinical laboratorians and clinicians. Categorizes biomarkers into diagnostic markers, disease follow-up markers, and prognostic biomarkers Include case examples to show the collaboration between the clinical laboratorian and clinician Discusses the application of kidney biomarkers in clinical practice along with addressing laboratory aspects of kidney biomarker determination

A biomarker is a molecule that is measured as a marker of normal biological processes, disease processes or the response to a diagnostic or therapeutic intervention. Kidney diseases like acute kidney injury, chronic kidney disease, diabetic nephropathy, glomerular disease, renal cancer and preeclampsia still have a high morbidity. Measurement of biomarkers in the blood or urine that detect patients at risk of kidney diseases or that detect kidney diseases in the earliest stage may ultimately result in preventative or earlier or more effective treatments for kidney diseases. Biomarkers of Kidney Disease reviews the basic and clinical research on biomarkers of the common kidney diseases including acute kidney injury, chronic kidney disease, renal cancer, diabetic nephropathy, glomerular disease and preeclampsia. The characteristics of an ideal biomarker of kidney diseases and statistical analysis of biomarker studies is detailed. The latest techniques for biomarker detection like metabolomics and proteomics is covered in the book. This comprehensive book details the latest advances made in the field of biomarker research and development in kidney diseases. The book is an ideal companion for those interested in biomarker research and development, proteomics and metabolomics, kidney diseases, statistical analysis, transplantation and preeclampsia. Presents a comprehensive, translational source for all aspects of renal biomarkers in one reference work Experts in renal disease biomarkers (from all areas of academic and medical research) take readers from the bench research (cellular and molecular mechanism) to new therapeutic approaches

This book provides important and updated information on current research devoted to urinary biomarkers. Urinary biomarkers are characteristics that can be objectively measured and evaluated as indicators of normal biological or pathogenic processes of pharmacological responses to therapeutic intervention.

Advances in long-term improvement and outcomes of patients with kidney disease will require the use of novel biomarkers to identify patients at high risk for kidney disease and to diagnose kidney disease early for effective treatment. A biomarker is a substance found in the blood, body fluids or tissues that provides a measure of normal biological or pathological processes or response to pharmacological compounds or drugs. There are a wide variety of biomarkers including but not limited to mRNA, proteins and peptides, and lipid molecules. In AKI, important pathophysiological processes such as inflammation, apoptotic and necrotic cell death and, tubule regeneration may be reflected in blood or urine. An array of candidate markers along with clinical information in long-term clinical studies with appropriate analytical methodologies will likely provide prognostic information. Despite well-known limitations, currently the most widely used biomarkers for the early diagnosis of CKD and AKI are proteinuria, serum creatinine and blood urea nitrogen. Most clinicians are aware that serum creatinine and blood urea nitrogen are poor biomarkers due to inherent characteristics of these molecules and handling by the kidney. Creatinine is secreted and urea nitrogen is reabsorbed by the renal tubules. Many endogenous substances interfere in the assay for creatinine. Serum creatinine and urea appear late after acute kidney injury and the serum levels in part depend on the generation (large or small body mass). Acute kidney injury is a non steady state condition thus serum creatinine and urea nitrogen will lag behind kidney injury. For these reasons new biomarkers are imperative. With knowledge of these limitations in use of current biomarkers and the lack of progress in reducing the mortality and morbidity from kidney disease, there has been a great surge of interest in identifying novel biomarkers with a particular emphasis on the early diagnosis of kidney disease. A variety of methods have been employed including transcriptomics, proteomics, gene arrays and lipidomics. Currently, candidate biomarkers have been found in different disorders and have been tested in humans and many candidate biomarkers have yet to be identified. Most studies to date are preliminary and require validation in large multicentre studies followed by commercial assay development validation and testing. This new book outlines the rapid advances made in the field of biomarker development for kidney disease in which a variety of novel molecules have been identified and studied in humans.

Associated with both acute kidney injury (AKI) and cardio-renal syndromes (CRS), new biomarkers represent both a popular area of investigation and a new opportunity for advancement of therapy. This book contains the resolutions of the most recent ADQI conferences on biomarkers in AKI (Dublin) and on cardio-renal syndromes (Venice). The first part answers specific questions about new biomarkers and their use and utility in AKI: What are the most suitable candidate molecules and physiologic measures, how solid and evidence based is the discovery phase? How can we incorporate the new biomarkers in the AKI conceptual model describing the evolution from susceptibility to insult, decreased GFR and organ death? Even if we have a positive biomarker pattern and we can identify patients at risk or patients with early or even subclinical AKI, how is this information affecting our clinical behavior and practice? The second part is dedicated to the appraisal of the current knowledge about the pathophysiological mechanisms involved in different forms of CRS: it contains contributions on the state-of-the-art knowledge and practice of CRS, particularly focusing on the pathophysiology of the five subtypes. Acute and chronic mechanisms of damage are explored in depth, with particular attention to the primacy of organ involvement and the subsequent pathways of organ crosstalk.Presenting the most recent research in the field of biomarkers, AKI and CRS, this publication is an important educational tool for advanced investigators and clinical experts, but also for students and fellows.

Acute Kidney Injury (AKI) is a complex syndrome that is prevalent among hospitalized patients. In recent years, occurrence of AKI events has risen due to a growing susceptibility of fragile and elderly subjects and an increase in the use of complex procedures such as cardiovascular surgery and imaging techniques. Exposure to potentially nephrotoxic drugs, such as new chemotherapeutic agents, is also proving to be a cause of AKI. This book summarizes recent advances in various settings. A reappraisal of current definitions and staging classifications for AKI in the literature is followed by a description of new criteria for identifying patients at risk and characterizing early kidney damage by using biomarkers. Other important topics include the sequelae of AKI and AKI in special populations such as children, the elderly, and those with cancer. The effects of AKI and its consequences on healthcare expenditures are also addressed from several perspectives. AKI management requires the cooperation of different specialists to optimize outcomes. This book is thus a perfect tool not only for nephrologists, but for every specialist involved in the complicated endeavor of improving patient care.

This book systematically summarizes the ideas and technologies used in urine proteome analysis. It argues that change is the core of biomarker definition since the body uses its homeostatic mechanisms to correct changes in the blood. This means that urine is probably a better source of biomarkers than blood. A roadmap to the urinary biomarker era is proposed, and researchers are reminded of the potential opportunities and risks in their study design. Kidney diseases are emphasized as they produce the most significant changes in urine. This book tries to show researchers and graduate students, who are in or entering the field, "all things considered" rather than "the current affair".

Renal diseases or kidney diseases are a set of chronic diseases or conditions that affect the functioning of the kidneys. They are classified into two major categories, namely, inflammatory kidney diseases (nephritis) or non-inflammatory kidney diseases (nephrosis). A biomarker or biologic marker is a measurable indicator of a specific biological state, particularly one relevant to the risk for, presence of, or stage of a disease. Biomarkers of renal diseases are used to screen and diagnose the activity of renal diseases, and guide molecularly targeted therapy or therapeutic response. The most accurate and promising biomarkers for detecting chronic kidney disease (CKD) are neutrophil gelatinase-associated lipocalin (NGAL), cystatin C and FGF-23. The risk stratification for the progression and mortality of kidney diseases can be improved by using ratio calculated by glomerular filtration rate (eGFR) and albuminuria (UACR). This book describes the most important biomarkers researched and studied in the context of renal diseases. Those in search of information to further their knowledge will be greatly assisted by it.