Personalised chronic kidney disease management on the horizon, as new biomarker research spurs hope

Biomarkers that could help predict and manage chronic kidney disease (CKD) have been identified in a new study led by the University of Surrey.

The research, funded by Kidney Research UK, and as part of the National Unified Renal Translational Research Enterprise (NURTuRE) CKD study, leveraged data on 2,884 adult CKD patients from across 16 nephrology centres – in which specialists study, prevent, diagnose and treat kidney disease.

The study, which has been published by the Journal of the American Society of Nephrology, examined 21 biomarkers linked to kidney damage, fibrosis, inflammation and cardiovascular disease.

Chronic kidney disease affects millions worldwide and is a major global health issue which is characterised by the gradual loss of kidney function over time, leading to serious health complications.

While established risk factors like age, sex, ethnicity, estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) remain strong predictors, the research found that a combination of biomarkers, namely sTNFR1, sCD40, UCOL1A1, could be key for predicting kidney failure. A different combination of biomarkers including hs-cTnT, NT-proBNP, suPAR were instead comparably good at predicting all-cause mortality (death from any cause).

Dr Tony Onoja, lead author of the study and Research Fellow at the University of Surrey, said:

"Our research shows that these novel biomarker models offer predictive results comparable to established methods, but the key finding here is that we can use these biomarkers to understand the underlying mechanisms of disease progression, potentially paving the way to more personalised treatments and medicines for CKD patients.”

The biomarker signatures identified provide insights into the underlying disease mechanism and associated processes linked to CKD’s progression, including extracellular matrix accumulation, chronic inflammation, and cardiovascular stress. These insights could inform the development of new targeted therapies and more personalised treatments.

Professor Nophar Geifman, senior author of the study and Professor of Health and Biomedical Informatics at the University of Surrey said:

"Our study demonstrates that specific biomarkers can offer a more nuanced understanding of a patient's disease progression and mortality risk and the disease’s ongoing activity. Further research is needed to evaluate how these biomarkers change in response to current treatments, and their clinical utility in patient care and in personalised medicine."

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