Summary: Serum creatinine and level of proteinuria, as biomarkers of chronic kidney disease
(CKD) progression, inadequately explain the variability of glomerular filtration rate
decline, and are late markers of glomerular filtration rate decline. Recent studies
have identified plasma and urine biomarkers at higher levels in children with CKD
and also associate independently with CKD progression, even after adjustment for serum
creatinine and proteinuria. These novel biomarkers represent diverse biologic pathways
of tubular injury, tubular dysfunction, inflammation, and tubular health, and can
be used as a liquid biopsy to better characterize CKD in children. In this review,
we highlight the biomarker findings from the Chronic Kidney Disease in Children cohort,
a large longitudinal study of children with CKD, and compare results with those from
other pediatric CKD cohorts. The biomarkers in focus in this review include plasma
kidney injury molecule-1, monocyte chemoattractant protein-1, fibroblast growth factor-23,
tumor necrosis factor receptor-1, tumor necrosis factor receptor-2, soluble urokinase
plasminogen activator receptor, and chitinase-3-like protein 1, as well as urine epidermal
growth factor, α-1 microglobulin, kidney injury molecule-1, monocyte chemoattractant
protein-1, and chitinase-3-like protein 1. Blood and urine biomarkers improve our
ability to prognosticate CKD progression and may improve our understanding of CKD
pathophysiology. Further research is required to establish how these biomarkers can
be used in the clinical setting to improve the clinical management of CKD.
Keywords
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Article info
Footnotes
Financial support: This research was supported by National Institutes of Health career development grant K08DK110536 (J.H.G.).
Conflict of interest statement: none.
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