Markery laboratoryjne przewlekłej niewydolności nerek oznaczane w surowicy i w moczu^a)

*Barbara Lisowska-Myjak

Summary
Chronic Kidney Disease (CKD) represents an evolving process which follows the initial renal insult and is characterized by progressive scarring that ultimately affects all structures of the kidney. The analysis of literature data demonstrates the role of numerous proteins, specifically related to the pathogenesis and development of successive stages of CKD. The methods of searching for new proteins as candidates for CKD markers, develop in two directions. Firstly, it is the association of particular proteins with recognized role in the pathogenesis of renal disease with specific clinical manifestations and secondly, using a proteomic approach and the latest developments in the field of protein research, the comparison of expression of all proteins present in the kidney and urine of healthy individuals and patients with renal disease, serves to identify diagnostically specific marker proteins. The development of laboratory guidelines on the use of these proteins as sensitive markers of kidney function must be preceded by numerous clinical studies in patients. The complex pathogenesis and development of CKD suggest that it will be not a single marker, but a strategic combination of selected proteins determined in serum and urine making up a „panel”, reflecting the state of renal function at successive stages of disease, useful for monitoring, prognosticating, and selecting effective treatment.
The aim of this article is to review the markers for impaired renal function now used in the medical laboratory as well as new promising candidates. The markers are measured in either serum (creatinine, cystatin C, ADMA, NGAL) or urine (proteinuria, cytokins, complement, KIM-1, NGAL, MMPs, TIMPs, PAI-1, AngII, ET-1, tTg) to assess the decrease in GFR and interstitial inflammation and fibrosis in the course of CKD.

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