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Biomarkers in Renal Disease (Hardcover, Illustrated Ed)
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Biomarkers in Renal Disease (Hardcover, Illustrated Ed)
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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.
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