Urinary markers of glomerular and tubular damage in chronic kidney disease

PhD ceremony: Mr. F.L. Nauta, 16.15 uur, Aula Academiegebouw, Broerstraat 5, Groningen

Dissertation: Urinary markers of glomerular and tubular damage in chronic kidney disease

Promotor(s): prof. P.E. de Jong

Faculty: Medical Sciences

In this thesis a number of new markers of kidney damage in urine were investigated, in particular their use in kidney disease. First, these markers can be of value to detect patients with kidney damage. In patients with diabetes mellitus we demonstrated that some markers were elevated without any other signs of kidney damage being present. Furthermore, these markers can be used to predict the prognosis of renal function in several kidney diseases. For example, in patients with a kidney transplant we investigated whether these markers can predict in which patients the function of the transplanted kidney will decline. Also, in persons without known kidney disease we studied whether these markers can predict progression of proteins in urine, which is considered a very early sign of kidney damage. A third purpose of these markers can be their use in medication titration in individual patients. These are promising developments, although the results need confirmation before they can be used in daily clinical practise. At present it is not entirely clear whether these markers are better, or can add predictive value to the most commonly used marker of renal damage, i.e., albumin excretion in urine.