Biomarkers in Kidney Health: Enhancing Early Detection and Treatments

Emerging biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) have shown great potential in the early diagnosis of kidney injury.

- Dr Ajay A Phadke, Pathologist, Agilus Diagnostics

These biomarkers are extremely sensitive indicators of tubular injury, and they can detect renal damage at stages when conventional markers are still within normal ranges. While these novel biomarkers have high sensitivity and specificity, incorporating them into ordinary clinical practice raises several problems. Despite its potential, more study is needed to validate these biomarkers in large-scale, long-term clinical studies.

Doctors rely on assessing kidney function to diagnose and manage kidney disease. For years, medical professionals have used traditional indicators such as serum creatinine, blood urea nitrogen (BUN), and the calculated estimated glomerular filtration rate (eGFR) to check and track kidney health. These tests are widely accessible and useful for monitoring the gradual loss of kidney function. However, they have a significant limitation: they often fail to detect problems until substantial kidney damage has already occurred. This is particularly concerning in glomerular diseases, where early damage may go unnoticed until the kidneys are severely impaired.

For patients at high risk of kidney problems—such as those with diabetes, high blood pressure, or a family history of kidney disease—the urinary microalbumin-to-creatinine ratio has become an important tool. This measurement can detect early kidney damage, even when blood creatinine levels appear normal by identifying small increases in albumin excretion in the urine. Early detection allows doctors to begin treatment sooner, potentially slowing the progression of chronic kidney disease (CKD) and reducing the risk of cardiovascular complications.