Evaluation and Validation of Seven Serum Biomarkers for Early Detection and Differentiation of Kidney Diseases in the Pakistani Population
Keywords:
Chronic kidney disease, Acute kidney injury, Biomarkers, Early detection, Serum analysisAbstract
Background: Early detection of kidney diseases is crucial to prevent progression to end-stage renal disease. Conventional markers like serum creatinine and eGFR often fail to detect subclinical renal injury, necessitating more sensitive and specific biomarkers.
Objective: This study aimed to evaluate and validate seven serum biomarkers—Klotho, Uromodulin, NGAL, Beta-2 Microglobulin (B2M), Asymmetric Dimethyl Arginine (ADMA), Beta Trace Protein (BTP), and Fetuin-A—for early detection and differentiation of chronic kidney disease (CKD) and acute kidney injury (AKI) in the Pakistani population.
Methods: A case-control study was conducted from March 2023 to January 2024 at Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan, including 210 participants (80 CKD, 70 AKI, 60 controls). Serum biomarker levels were measured using enzyme-linked immunosorbent assay (ELISA) kits. Diagnostic performance was assessed via receiver operating characteristic (ROC) curve analysis, and inter-biomarker correlations were evaluated using matrix scatter plots. Protein-protein interactions were explored using STRING. Statistical analysis was performed using one-way ANOVA followed by Tukey’s multiple comparison test, with p < 0.05 considered significant.
Results: CKD and AKI patients exhibited significantly elevated serum creatinine and reduced eGFR compared to controls (p < 0.001). NGAL, B2M, ADMA, and BTP were significantly higher in CKD and AKI, while Uromodulin and Klotho showed differential patterns. ROC analysis revealed high diagnostic accuracy for BTP (AUC = 0.991), NGAL (AUC = 0.988), and ADMA (AUC = 0.977). Strong correlations among biomarkers and STRING analysis indicated potential mechanistic interactions in renal injury.
Conclusions: BTP, NGAL, ADMA, Klotho, and Uromodulin are promising biomarkers for early detection and differentiation of CKD and AKI, supporting timely clinical interventions.
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