| Histopathology is the gold standard for defining renal injury, but it is invasive, timeconsuming
and expensive, plus it is seldom used in subjects with mild renal injury.
Using biomarkers linked to distinct, defined cell types and tissues provides a direct
link to histopathology without its drawbacks, and provides increased sensitivity and
specificity. The nephron consists of several sections, each with its own specific
biomarkers; therefore, through the use of a battery of tests, injuries can be localised
to distinct areas.
Cell-specific biomarkers have been
known about for over 40 years, but they
are still underused in renal medicine
and research. In particular, there are
few studies where they have been used
to guide therapy or been linked to
quantitative changes in the kidney. This
article will discuss how using biomarkers
with a known cellular origin may help
renal effects to be found earlier and at
lower levels of injury. Their potential
uses in renal medicine and clinical
research will then be presented.
Renal diseases are an expanding
problem; half a million Americans could
be on dialysis in 2010 at a cost of $46
billion dollars a year (1). Even so, renal
injury may be an under-recognised
problem due in part to the ability of the
kidneys to regenerate, as well as their
great reserve capacity. The most common
test of renal function is serum creatinine. |
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