Biomarkers of Kidney Injury and Disease Progression

Biomarkers of kidney injury and disease progression encompass molecules detectable in blood or urine that reflect structural damage, functional impairment or molecular pathways active in the diseased kidney. Traditional measures such as serum creatinine, cystatin C and estimated glomerular filtration rate remain the clinical mainstays for assessing glomerular function, yet they lack sensitivity for early tubular injury and often change only after substantial nephron loss. Advances in molecular biology have identified markers of tubular cell stress and injury – for example kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin – alongside indicators of interstitial fibrosis, inflammation and repair. Beyond single analytes, high-throughput techniques in proteomics, transcriptomics and metabolomics permit multiplex profiling of panels of proteins and RNAs, yielding composite signatures that better discriminate acute from chronic injury and may predict progression to end-stage kidney disease. Integrating these markers with clinical variables and applying machine-learning algorithms enhances risk stratification, informs therapeutic decisions and supports the development of precision-medicine approaches in nephrology. The global rise in chronic kidney disease and the close links between renal dysfunction and cardiovascular risk underline the urgent need for validated biomarkers that can guide early intervention, monitor treatment response and improve outcomes across diverse patient populations.

Research from Nature Portfolio

Utilising a custom multiplex assay to measure 21 proteins in plasma and urine, researchers characterised distinct biomarker profiles in healthy controls, critically ill patients with acute kidney injury and individuals with chronic or end-stage kidney disease. Specific markers in plasma, such as tissue inhibitor of metalloproteinases-1 and trefoil factor 3, exhibited high predictive value for acute versus chronic injury, while urinary osteoactivin and β2-microglobulin distinguished injury subtypes with strong positive and negative predictive values. Correlations between marker levels and clinical laboratory variables were mapped, and machine-learning models refined the capacity to classify disease states. This work demonstrates the feasibility of combining conventional statistics with computational approaches to derive biomarker panels that capture the spectrum of kidney injury and may inform hypothesis-driven research on disease mechanisms and therapeutic targets.

Biomarkers of Kidney Injury and Disease Progression publication trend

The graph below shows the total number of articles in biomarkers of kidney injury and disease progression across all publications each year (not limited to Nature Index journals).

Technical terms

Acute kidney injury (AKI): A rapid decline in renal function resulting from tubular cell damage or haemodynamic changes, often detected by abrupt increases in serum creatinine or novel tubular injury markers.

Chronic kidney disease (CKD): A progressive loss of kidney function over months or years, defined by persistent reductions in glomerular filtration or signs of kidney damage.

Estimated glomerular filtration rate (eGFR): A calculated index of kidney filtration capacity based on serum creatinine, age, sex and ethnicity, used to stage CKD.

Kidney injury molecule-1 (KIM-1): A transmembrane glycoprotein upregulated in proximal tubular cells after injury, excreted in urine and serving as an early marker of tubular damage.

Neutrophil gelatinase-associated lipocalin (NGAL): A small protein released by injured tubular cells and neutrophils, measurable in blood or urine and indicative of acute or chronic tubular injury.

Multiplex biomarker panel: An assay that simultaneously measures multiple proteins or analytes in a single sample to generate a composite disease signature.

References

1. Urinary Biomarkers Of Kidney Function As Predictors Of Cardiovascular Health: A Systematic Review. Current Hypertension Reports (2025).
2. Effects of Mineralocorticoid Receptor Blockade and Statins on Kidney Injury Marker 1 (KIM-1) in Female Rats Receiving L-NAME and Angiotensin II. International Journal of Molecular Sciences (2023).
3. Plasma Neutrophil Gelatinase-Associated Lipocalin Associates with New-Onset Chronic Kidney Disease in the General Population. Biomolecules (2023).
4. A novel multiplex biomarker panel for profiling human acute and chronic kidney disease. Scientific Reports (2023).
5. Emerging Biomarkers for Early Detection of Chronic Kidney Disease. Journal of Personalized Medicine (2022).