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Article Number: EC/2014/117

Authors: Avi Nahar, P. Suresh Kumar

Topic: Clinical Research


Clinical diagnosis and therapeutic management from an earlier stage of diabetic nephropathy (DN) is of prime significance in prevention of progression of DN to ESRD. There are several biomarkers used to investigate & detect kidney damage. Conventional biomarkers for kidney damage include glomerular filtration rate (GFR), serum/plasma creatinine, blood urea nitrogen (BUN), urinary micro-albumin excretion and several urinary findings such as proteinuria and hematuria. However, these biomarkers are non-specific and insensitive to early renal injury. Hence, new specific markers are being developed. (2) This article lists eight such novel bio-markers i.e. Kidney injury molecule-1 (KIM-1),Neutrophil gelatinase-associated lipocalin (NGAL), Inflammatory Marker IL-6, Lipoprotein Lipase (LPL), CD36, IL 10, Apo lipoprotein E (apoE), Low density lipoprotein receptor (LDLr) & reviews the various studies being done to their role in early detection of renal injury.


    COMMENT - 1

  • SADAF TABASSUM (Viewer) 29th Jan 2015 - 11:58 PM
    A biomarker is a characteristic that is objectively measured and evaluated as an indicator of normal biological or pathogenic processes, or pharmacologic responses to a therapeutic intervention.At present, serum creatinine, which is used to measure the glomerular filtration rate (GFR), is the most commonly used marker of renal function. Unfortunately, serum creatinine is a delayed and unreliable indicator of acute kidney injury (AKI),

  • COMMENT - 2

  • AUGUSTINE ANAYOCHUKWU ONYEAGHALA (Viewer) 30th Jan 2015 - 2:56 AM
    A good bio maker should be sensitive, predictive, specific and measurable. considering the poor sensitive nature of the currently available bio makers for liver and kidney disease including cardiac systems, there is a serious urgent need to develop and validate current ones. This will improve the clinical research outcome and help greatly in approving reliable drugs with minimal toxicities.

  • COMMENT - 3

  • AVI NAHAR (Author) 7th Feb 2015 - 6:41 PM
    Dear Ms. Sadaf & Mr. Augustine,
    Thank you for the comments! As rightly mentioned, conventional markers like S.Creatinine are raised very late & most of the irreversible damage is already done by the time they are altered. A bimarker which can detect the renal cell injury at a reversible stage is need of the hour. Will surely help volunteers of Clinical Drug trial too in early detection of cell injury.

  • COMMENT - 4

  • AUGUSTINE ANAYOCHUKWU ONYEAGHALA (Viewer) 8th Feb 2015 - 1:42 AM
    It will be good for clinical research process to focus mainly on predictive assessment of biomarkers of toxicity instead of the current 'diagnostic' measurements which may produce some kind of misinterpretations about the efficacy and safety of INDs. I strongly recommend that future protocols developed for clinical trial of INDs should include the assessment of newer predictive markers.

  • COMMENT - 5

  • AVI NAHAR (Author) 8th Feb 2015 - 11:26 AM
    Dear Mr. Augustine,
    I agree with your recommendation. We are moving in a direction of Preventive Health Care rather than Curative. And thus it is all the more important that Clinical Researchers take up the novel markers for predicting the imminent cell injury.This will not only be physically beneficial but also reduce the financial burden of the society at large.

  • COMMENT - 6

  • RAHUL TULSHIRAM INGALE (Viewer) 9th Feb 2015 - 6:15 PM
    Dear Avi,

    Nice Article but would recommend for more research. A bimarker which can detect the renal cell injury at a reversible stage is need of the prsence.


    • AVI NAHAR (Author) 9th Feb 2015 - 6:26 PM
      Totally agree with you Mr. Rahul, most of these markers are still under very initial stages to be labelled as specific. More research & trials on the same would help in establishing their positive & negative predictive value!

  • COMMENT - 7

  • ANIL EKNATH KHEDKAR (Viewer) 9th Feb 2015 - 9:55 PM
    Dear Avi Nahar,

    Good article on emphasis on novel biomarkers for renal disease. We need good quality, long-term, large longitudinal trials to validate published biomarkers and find new biomarkers, considering biomarkers needs to be reviewed here from small cross-sectional studies.