BBB seminar: Hans-Peter Marti
Where do we need biomarkers in kidney diseases?
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Hans-Peter Marti
Department of Clinical Medicine, Haukeland University Hospital, University of Bergen
The prevention or attenuation of the severity of disease necessitates an early detection. Biomarkers used in nephrology are often considered to represent parameters that can be analyzed from blood or urine specimens, although they can also be detected and quantified from biopsy specimens or from any type of renal imaging modality.
Kidney diseases like acute kidney injury, chronic kidney disease (including renal fibrosis), diabetic nephropathy, glomerular disease, renal cancer and kidney transplant rejection still have a high morbidity. Measurements of biomarkers especially in the blood or urine and in kidney biopsy specimens that detect patients at risk of renal diseases or that detect kidney diseases in the earliest stage may ultimately result in better prevention strategies and in more effective treatments.
This talk will review the basic and clinical research on biomarkers of the common kidney diseases with a special focus on acute kidney injury and on renal transplant rejection processes. Currently used clinical tests based on circulating creatinine levels - which may not rise in patient serum until 24 to 48 hours after an acute injury episode - are insufficiently sensitive or specific to detect acute kidney injury early enough. With delays in diagnosis, clinicians miss opportunities to minimize tissue damage, and patients sustain more severe kidney impairment with subsequent greater risk of developing chronic kidney disease. Neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) are examples of promising candidate biomarkers for acute kidney injury. In transplant medicine, acute and chronic rejection processes are most important etiologies of renal allograft loss. Kidney transplant rejection must be diagnosed prior to overt histological allograft damage. Respective biomarker panels allowing a timely and more precise diagnosis of T and B lymphocyte-mediated processes of renal allograft rejection are entering their clinical usage.
Chairperson: Helge Wiig <helge.wiig@biomed.uib.no>, Department of Biomedicine
