Urinary Biomarkers in Glomerulonephritis

Abstract

A biomarker refers to a biologic, biochemical or molecular event that can be assayed qualitatively and quantitatively by laboratory techniques. The level of biomarkers should correlate with disease pathogenesis or activity. Biomarker discovery for kidney diseases is currently an active area of investigation. Today golden standard for diagnosis and for evaluation of treatment results is kidney biopsy – an invasive test with considerable risks. Biomarkers have the potential to be useful tools for non invasive evaluation and management of patients suffering from glomerulonephritis. Biomarkers that predict impending disease activity could be used to initiate treatment early, which could minimize the initial insult, allow a reduction in duration and intensity of therapy, improve outcomes and lessen chronic renal injury. Biomarkers that predict response to therapy could be used to choose the most appropriate regimen for an individual patient and biomarkers that reflect disease severity could be used to adjust the intensity of therapy. Profiles as well as individual markers, with the potential to reduce the use of renal biopsy, improve therapeutic efficacy, and limit toxicity are emerging and this chapter will describe some examples in the context of IgA nephropathy, lupus nephritis, ANCA-associated small vessel vasculitis (ASVV) with renal involvement and focal segmental glomerulosclerosis (FSGS).