New biomarkers may offer a more sensitive approach for monitoring kidney health

Drug-induced kidney injury, or nephrotoxicity, is a common complication in clinical medicine that happens when drugs damage the kidneys. Nephrotoxicity can occur with anti-inflammatory, antibacterial, antiretroviral, or chemotherapeutic medicines and can lead to therapies being discontinued or restricted from patients. Now, researchers have identified six new biomarkers that could detect kidney injury faster and with more sensitivity, advancing safer drug development and improving health outcomes for patients. 

The findings were published recently in Clinical Pharmacology & Therapeutics. Sushrut Waikar, MD, MPH, first author on the paper, says these new biomarkers may offer a more sensitive approach than existing standards for monitoring kidney health and can lead to more tolerable treatment options. 

Current biomarkers can be too slow at showing early signs of kidney injury. These biomarkers, which can be measured in the urine, could help clinicians detect kidney damage within 24 hours of injury, enabling more timely monitoring during drug development and better treatment of patients who are at risk in clinical settings." 

Sushrut Waikar, MD, MPH, Chief of Nephrology and Interim Medicine Chair, Boston Medical Center

 The research team examined urinary levels of protein biomarkers in healthy volunteers and patients undergoing treatment for mesothelioma with a chemotherapy drug that is known to have toxic effects on the kidneys. 

The six biomarkers identified by the team are mostly made in the kidneys themselves in response to injury or inflammation. This enables detection of kidney injury more quickly than current blood tests, like serum creatinine, which can sometimes take several days to reach abnormal levels. 

The research team now hopes to assess whether these biomarkers can be used more broadly to monitor kidney health in clinical trial settings. 

Earlier detection of kidney damage could allow clinicians to intervene sooner, reducing the risk of long-term damage and improving patient outcomes across all settings. "These biomarkers have the potential to make a real difference in how we monitor kidney health and manage patients at risk for kidney damage," says Waikar, who is also the Norman G. Levinsky Professor of Medicine at Boston University Chobanian & Avedisian School of Medicine. "We are hopeful that these findings will contribute to better strategies for preserving kidney function and improving patient care, as well as advancing safer drug development."