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Chronic kidney disease is an irreversible kidney damage caused by structural or functional renal impairment and persisting for more than 3 months. It is usually accompanied by albuminuria, proteinuria, abnormal histopathological and imaging findings as well as a drop in glomerular filtration rate below 60 mL/min/1.73 m2. Due to the increasing number of patients, chronic kidney disease is referred to as “the epidemic of the 21st century.” Early diagnosis allows for effective therapeutic intervention, which makes it possible to inhibit pathological processes and prevent disease in the future. Diagnostic difficulties in detecting early stages of chronic kidney disease are due to their asymptomatic nature and the fact that the markers widely used for renal function assessment are not very sensitive. Therefore, new, early, sensitive and specific markers of renal damage, whose introduction in everyday clinical practice would give a chance of a diagnosis at the very onset of the disease, before irreversible changes occur, are currently being sought. Although the results of scientific research are ambiguous, some of the candidate protein markers seem very promising. These include uromodulin, KIM-1, NGAL-1, NAG, FGF23, RBP4 and suPAR. The aim of the paper was to present a review of the latest research on the use of novel protein markers in the diagnosis of chronic kidney disease in paediatric and internal medicine patients.

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Background. Some forms of idiopathic nephrotic syndrome (INS) are treated with cyclosporine a (CsA) as an alternative method. a serious adverse effect of the drug is nephrotoxicity. to help optimize the therapy, researchers are looking for early kidney injury markers. Objectives. to determine KIM-1 (kidney injury molecule-1) plasma and urine concentrations in children with ins and to evaluate the suitability of the protein as CsA nephrotoxicity marker. Material and methods. 30 children with steroid-dependent (sDns) and steroid-resistant (SRNS) ins and 22 healthy children were enrolled to the study. kiM-1 plasma and urine concentrations were determined in children with ins before the administration of CsA, and then after 6 and 12 months, using the enzyme-linked immunosorbent assay (Elisa). Results. in the ins group, higher KIM-1 plasma and urine concentration were observed prior to the administration of CsA compared to the reference group. During the follow-up period, KIM-1 plasma levels were increasing, and the values varied significantly at all time points. KIM-1 urine levels after 6 and 12 months of therapy were significantly higher compared to baseline, and, statistically, did not vary significantly when determined between 6 and 12 months of treatment. no correlation was found between KIM-1 urine concentrations and CsA blood levels, proteinuria or eGFR. the parameters analysed in plasma and urine of sDns and srns diagnosed patients, did not vary significantly. Conclusions. urine KIM-1 concentration were found to vary in ins children treated with CsA, which suggests that the protein may be suitable for monitoring these patients. [ABSTRACT FROM AUTHOR]

On the basis of scientific literature, there is growing evidence that KIM-1 and NGAL are interesting and promising biomarkers not only in acute and chronic inflammatory processes but also in oncogenesis. There are a number of studies which investigate their possible use in diagnosis, treatment and monitoring of therapy effectiveness. The results of recent research suggests that they may play an important role in standard oncology practice. Simultaneous measurement of KIM-1 and NGAL in urine can play a crucial role in carcinogenesis assessment and cancer progression. In the future, they can become rapid diagnostic indicators, which allow one to determine cancer subtype leading to biopsy replacement and therapy improvement. In the present work, beside biochemical characteristics of KIM-1 and NGAL, we will also discuss their role in the diagnosis and assessment of development of cancer. [ABSTRACT FROM AUTHOR]

In recent years, the rapid development of scientific research led to the introduction of strategies based on new markers that allow for estimation of the latent disease period before the clinical symptoms of actual kidney failure are revealed. The experimental tests carried out on animals and cell lines derived from the proximal tubule have made possible the detection of genes that are induced early after hypoxia [1]. The protein products of these genes can be considered as useful markers for the diagnosis of renal failure. The induction of gene KIM-1 (called Kidney Injury Molecule-1) results in the formation of protein that can be considered as a diagnostic marker. This work describes the data on the structure, biological function and importance of determining the concentrations of KIM-1 in the diagnosis of drug-induced toxicity and kidney damage [ABSTRACT FROM AUTHOR]