Biomarker | Patho-physiological basis | Number of patients | Definition progression | Evidence to date |
---|---|---|---|---|
Cystatin C | Marker of kidney function [123] | 117 | Doubling serum creatinine or ESKD | Cystatin C predicted renal decline (doubling of Creatinine or arrival at ESKD) in the MMKD study [124] |
Neutrophil Gelatinase-Associated Lipocalin (NGAL) | Marker of tubulo-interstitial injury [125] | 96 | Doubling serum creatinine | Serum and urine NGAL was associated with renal decline (doubling of serum creatinine) [126] |
Asymmetric Dimethylarginine (ADMA) | Marker of endothelial dysfunction [127] | 225 | Increased proteinuria, rate of change of eGFR | A study of 225 diabetics found that ADMA was associated with renal progression (increase in proteinuria, rate of change of eGFR) [128] |
227 | Doubling serum creatinine or arrival at ESKD | |||
131 | Arrival at ESKD | ADMA levels above the median were more likely to reach an endpoint [129] | ||
ADMA was an independent risk factor for renal progression [130] | ||||
B-type Natriuretic protein (BNP) | Marker of cardiovascular dysfunction [131] | 227 | Doubling serum creatinine or arrival at ESKD | Elevated BNP and pro BNP were associated with progression to end points [132] |
 |  | 382 | Arrival at ESKD | BNP correlated strongly with risk of mortality but not progression of CKD [38] |
Homocysteine (Hcy) | Marker of endothelial dysfunction [133] | 316 | Development of albuminuria from normoalbuminuria | Hyperhomocysteinaemia was a predicted the development is albuminuria [134] |
C-reactive protein (CRP) | Marker of inflammation | 804 | Rate of change of eGFR | Neither serum CRP or leptin predicted renal progression [135] |
Adiponectin | Marker of metabolic disturbance [136] | 1330 | Arrival at ESKD | The group of patients with microalbuminuria who progressed to ESRF had higher adiponectin levels [137] |
Free light chains (FLCs) | Marker of renal function and possible inflammation [138] | 282 healthy controls, 772 South Asian diabetics, 91 Caucasian diabetics | Development of microalbuminuria | Elevated serum FLCs were a risk factor for the development of microalbuminuria [138] |
Fibroblast growth factor 23 (FGF 23) | Marker of metabolic disturbance [139] | 227 non-diabetics with normal renal function and CKD (GFR>60 = 121, GFR<60 =106 | Doubling serum creatinine or arrival at ESKD | Both c-terminal and intact FGF23 independently predicted progression of CKD after adjustment for age/gender/GFR and proteinuria [139] |
Urinary MCP1 | MCP-1/CCL2 is a chemokine which is upregulated in CKD [140, 141] | 215 patients with CKD undergoing a renal biospy | Doubling of serum creatinine or arrival at ESKD | ACR, urinary MCP-1 and interstial macrophage numbes were interdependent. ACR, macrophage numbers chronic damage and creatinine predicted renal survival [142] |