Biomarker Applications in Diabetic Kidney Disease

Diabetic kidney disease is a leading cause of chronic kidney failure worldwide, and the identification of sensitive and specific biomarkers has become central to early diagnosis, risk stratification and therapeutic monitoring. Biomarkers derived from blood and urine—including proteins, metabolites and nucleic acids—are being investigated to predict the onset and progression of renal injury before conventional measures become abnormal. Recent advances in proteomics, transcriptomics and metabolomics have revealed panels of markers reflecting inflammation, fibrosis, endothelial dysfunction and glomerular filtration. These markers complement traditional assessments such as estimated glomerular filtration rate and albuminuria by offering mechanistic insight into pathophysiological pathways, enabling personalised risk prediction and the design of targeted interventions. Multi-marker algorithms, often supported by machine-learning approaches, further improve prognostic accuracy, while point-of-care assays for selected proteins promise wider clinical implementation. The global burden of diabetic kidney disease underscores the need for validated biomarkers that can guide screening, inform therapeutic decisions and ultimately improve renal outcomes and survival.

Research from Nature Portfolio

Recent studies have demonstrated that elevated circulating levels of tumour necrosis factor receptors 1 and 2 are independent predictors of both cardiovascular and all-cause mortality in patients undergoing haemodialysis. Analysis of dialysis cohorts revealed strong correlations between receptor concentrations and adverse outcomes, even after accounting for age, blood pressure and pre-existing cardiovascular disease. These findings highlight the prognostic utility of inflammatory receptor biomarkers in advanced renal failure and support their potential role in refining risk assessment strategies for patients with diabetic kidney disease.

Biomarker Applications in Diabetic Kidney Disease publication trend

The graph below shows the total number of articles in biomarker applications in diabetic kidney disease across all publications each year (not limited to Nature Index journals).

Technical terms

Biomarker: A measurable substance in blood or urine that indicates normal or pathogenic processes or responses to therapy.

eGFR (estimated glomerular filtration rate): A calculated measure of kidney filtration function based on serum creatinine and demographic factors.

Albuminuria: The presence of albumin in the urine, reflecting glomerular injury and a risk factor for renal progression.

Tumour necrosis factor receptors (TNFRs): Membrane or soluble proteins that mediate inflammatory signalling and are linked to renal injury and outcomes.

Kidney injury molecule 1 (KIM-1): An epithelial cell protein upregulated in proximal tubule injury, serving as an early marker of renal damage.

High mobility group box 1 (HMGB1): A damage-associated molecular pattern protein released during cell stress, associated with inflammation and renal disease progression.

References

1. Different roles of protein biomarkers predicting eGFR trajectories in people with chronic kidney disease and diabetes mellitus: a nationwide retrospective cohort study. Cardiovascular Diabetology (2023).
2. Proteomic profiling of longitudinal changes in kidney function among middle-aged and older men and women: the KORA S4/F4/FF4 study. BMC Medicine (2023).
3. Serum high mobility group box 1 as a potential biomarker for the progression of kidney disease in patients with type 2 diabetes. Frontiers in Immunology (2024).
4. Circulating TNF Receptors 1 and 2 Predict Mortality in Patients with End-stage Renal Disease Undergoing Dialysis. Scientific Reports (2017).