Harnessing Biomarkers: Advancing Prognosis and Management in Chronic Kidney Disease

Chronic kidney disease (CKD) continues to pose significant challenges in both diagnostic accuracy and effective management. The integration of select biomarkers into clinical practice offers promising advancements that may enhance risk stratification and staging, consistent with current guideline recommendations that use cystatin C as an adjunct for GFR estimation.

A University of Surrey-led analysis reported candidate urinary proteomic peptide signatures associated with CKD progression; as an observational discovery study, the findings suggest potential to stratify risk of faster eGFR decline or progression to advanced CKD but do not establish practice change.

Among routinely available measures, cystatin C improves GFR estimation and risk stratification. Molecular profiling, such as the emerging urinary proteomic signatures noted above, is an active area of research that may one day support more tailored monitoring, aligning with the longer-term aspiration of precision nephrology.

Biomarker panels may refine risk stratification and inform when to escalate care; definitive outcome improvements await trial data.

Key Takeaways:

• Cystatin C and albuminuria complement creatinine to improve CKD staging and risk stratification.
• Emerging urinary proteomic signatures may help flag faster progression earlier, pending validation.
• Biomarkers can support more timely and targeted monitoring; outcome benefits require prospective trials.