Diagnostic and prognostic biomarkers for tubulointerstitial fibrosis.

Abstract

Renal fibrosis is the final common pathophysiological pathway in chronic kidney disease (CKD) regardless of the underlying cause of kidney injury. Tubulointerstitial fibrosis (TIF) is considered to be the key pathological predictor of CKD progression. Currently, the gold standard tool to identify TIF is kidney biopsy, an invasive method that carries risks. Non-invasive diagnostics rely on an estimation of glomerular filtration rate (eGFR) and albuminuria that assess kidney function, but these fail to accurately diagnose early CKD, and predict progressive decline in kidney function. In this review we summarize the current and emerging molecular biomarkers which have been studied in various clinical settings and in animal models of kidney disease and which correlate with the degree of TIF. We examine the potential of these biomarkers to non-invasively diagnose TIF and predict disease progression. We also examine the potential of novel technologies and non-invasive diagnostic approaches in assessing TIF. Limitations of current and potential biomarkers are discussed, and knowledge gaps are identified. Abstract figure legend The best predictor of chronic kidney disease (CKD) is tubulointerstitial fibrosis (TIF). Kidney biopsy is the gold standard diagnostic method for TIF, which is invasive. Non-invasive methods might involve assessing kidney function, identifying potential urinary and blood biomarkers, and using novel technologies. Assessing kidney function by measuring glomerular filtration rate and albuminuria has poor diagnostic and prognostic accuracy for TIF. In this review, we present current and potential soluble biomarkers and novel technologies and discuss their diagnostic and prognostic accuracies. This article is protected by copyright. All rights reserved.