[Frontiers in Bioscience S2, 591-615, January 1, 2010]

Clinical biomarkers in kidney diseases

Francesca Bonomini1, Eleonora Foglio1, Luigi Fabrizio Rodella1, Rita Rezzani1

1Unit of Human Anatomy, Department of Biomedical Sciences and Biotechnology, University of Brescia


1. Abstract
2. Introduction
3.Acute Renal Failure
3.1. Causes of ARF in the critically ill patient
3.2. Histopathology of ARF
3.3. Epidemiology of ARF
3.4. Definition and classification systems for ARF
3.4.1. RIFLE classification
3.4.2. Modifications of the RIFLE criteria
3.5. Diagnostic approach
3.6. Emerging biomarkers for AKI
3.6.1. Interleukin-18
3.6.2. Neutrophil Gelatinase-Associated Lipocalin
3.6.3. Kidney injury molecule-1
3.6.4. Cystatin C
3.6.5. Fatty Acid-Binding Protein
3.6.6. Other biomarkers
3.6.7. Tubular enzymes and markers of tubular dysfunction
4. Biomarkers for monitoring progression from acute to chronic kidney diseases
5. Chronic Kidney Disease
5.1. Histopathology of CKD
5.2. Emerging biomarkers for CKD
5.2.1. Neutrophil Gelatinase-Associated Lipocalin
5.2.2. Cystatin C
5.2.3. Asymmetric Dimethylarginine
5.2.4. Liver associated- Fatty Acid-Binding Protein
6. Summary and Perspective
7. Ackowledgements


Biomarkers are "biological parameters that can be objectively measured and evaluated, which act as indicators of normal or pathogenic processes, or of the pharmacological response to a therapeutic intervention" .Renal failure can be broadly divided in acute and chronic renal diseases, two classes of renal pathology that are well distinct each other, not only on the basis of duration and reversibility of loss of kidney function, but also because of their different aetiopathological processes and their different histopathological characteristics.Unlikely, the conventional measures used for monitoring kidney function are not ideal in the diagnosis of neither acute or chronic kidney diseases and has impaired our ability to institute potentially effective therapies.Therefore, researchers are seeking new early, predictive, non-invasive biomarkers that can aid in the diagnosis for both acute and chronic diseases.These biomarkers will be useful for assessing the duration and severity of kidney disease, and for predicting progression and adverse clinical outcomes.This review article summarized our current understanding of the acute and chronic renal diseases and discussed the most promising biomarkers for facilitating early detection and predicting clinical outcomes.