Urinary Proteomics in Kidney Transplantation

Abstract

Although kidney transplantation is the best treatment option for end stage kidney disease, it is still associated with long-term graft failure. One of the greater challenges for transplant professionals is the ability to identify grafts with a high risk of failure before initial decline of eGFR with irreversible graft changes. Transplantation medicine is facing an emerging need for novel disease end point-specific biomarkers, with practical application in preventive screening, early diagnostic, and improved prognostic and therapeutic utility. The aim of our review was to evaluate the clinical application of urinary proteomics in kidney transplant recipients at risk for any type of future graft failure.

Proteomics: Its Promise and Pitfalls in Shaping Precision Medicine in Solid Organ Transplantation

“…Prior observations suggested that a single biomarker is not likely to reflect the complex pathophysiological process in solid organ transplantation. 31,159 This notion, combined with the advent of a plethora of computational methods, has justified the preference toward the development of proteomic classifiers or protein panels. Additionally, integration of proteomics data with those from other techniques, such as genomics, transcriptomics, and metabolomics, is expected to provide more comprehensive snapshots and a deeper understanding of the mechanisms involved in the pathophysiology after solid organ transplantation.…”

“…Several biological specimens have been harnessed for the discovery of proteomic biomarkers, including, but not limited to, tissue samples, whole-blood, serum, plasma, urine, bronchoalveolar lavage (BAL). 28,29 Because of the minimally invasive procedure through which blood 30 and urine 31 are collected, these 2 biofluids have been preferred over biopsies in studies aiming to identify markers for clinical applications.…”