Novel protein biomarkers for risk stratification and personalized medicine - PubMed
3 hours ago
- #chronic kidney disease
- #biomarkers
- #personalized medicine
- Novel protein biomarkers like urinary clusterin and epidermal growth factor (uEGF) are studied for risk stratification and personalized medicine in chronic kidney disease (CKD).
- Albuminuria is commonly used but has limitations; urinary clusterin and uEGF provide insights into tubular injury and repair, respectively.
- Two randomized CKD trials (SONAR and DAPA-CKD) evaluated changes in urinary biomarkers in response to endothelin receptor antagonists (ERA) and sodium-glucose cotransporter 2 inhibitors (SGLT2i).
- Atrasentan (ERA) reduced urinary clusterin-to-creatinine ratio (uCLU/Cr) by 46.3% and increased serum endothelin-1 (ET-1) by 23.4%.
- Dapagliflozin (SGLT2i) attenuated the decline in uEGF-to-creatinine ratio (uEGF/Cr), with effects varying by CKD etiology, diabetes status, and glycemic control.
- Tubular EGF mRNA expression positively correlated with uEGF/Cr, supporting its role as a biomarker for tubular repair.
- These biomarkers complement albuminuria by capturing distinct intrarenal pathways, offering a more comprehensive assessment of treatment effects in CKD.