Biomarkers for Chronic Kidney Disease: An Updated Review of Innovative Detection Approaches.

Abstract

Background: Chronic kidney disease (CKD) is a progressive and incurable condition that impairs kidney function over time. Affecting approximately 13% of the global population, CKD poses a substantial economic burden on healthcare systems and significantly reduces both the quality and duration of life for affected individuals. The overview of innovative methods will facilitate the identification and documentation of novel biomarkers associated with kidney diseases.

Aim: This review summarizes the findings of previous studies associated with novel therapeutic approaches and biomarkers for the early detection of CKD.

Materials and methods: All relevant databases were searched for published articles on the topic of interest from the beginning of the study period up to April 2025, using the following search terms: "Chronic Kidney Disease," "Conventional Biomarkers," and "Novel Biomarkers." We also reviewed the reference lists of eligible studies, previous review articles, and registered clinical trials. A total of 101 manuscripts were included in this evaluation.

Results: To comprehensively understand the diverse changes resulting from the complex pathomechanisms of CKD, the use of a combination of biomarkers is recommended. Relying solely on creatinine levels, estimated glomerular filtration rate (eGFR), and proteinuria may be insufficient for accurate diagnosis. However, for the diagnosis, monitoring of progression, and assessment of disease severity, direct measurement of glomerular filtration rate (GFR) remains the most reliable and optimal approach. Glomerular, tubular, and tissue integrity of endothelial and epithelial cells in the nephron could be representative of morphophysiological changes associated with CKD. Albumin and creatinine are not sufficient for clinical application in the early detection of CKD. The published articles reported urea/BUN, creatinine, and cystatin C as the functional biomarkers. Injury biomarkers included: proteinuria, hematuria, creatinine (when > 40% kidney parenchyma is damaged), cystatin C, podocytes, podocalyxin, Nephrin, Podocin, CR1, CD80, synaptopodin, GLEPP-1, CD59, WT1, and CD59. For CKD progression, measuring DKK3, CKD273, hL-FABP, Fetuin-A, and Scd25 might offer valuable information.

Conclusion: Different biomarkers should be deliberated regarding the early detection of CKD based on their sensitivity, efficacy, specificity, and, of course, cost benefits for both patients and health system decision makers, which confer relevance.