In patients with kidney illness, biomarkers for noninvasive evaluation of histology and prognosis are required. In a prospective cohort study of 549 patients with biopsy-confirmed kidney disorders and semiquantitative evaluation of histopathology, researchers evaluated a multimarker panel of 225 circulating plasma proteins using a proteomics assay. They investigated the relationships between each biomarker and histopathologic lesions, as well as the risks of renal disease progression (defined as a 40% reduction in eGFR or the commencement of KRT) and mortality.
After multivariable adjustment and multiple testing corrections, 46 distinct proteins were linked to histopathologic lesions. Kidney injury molecule-1 (KIM-1) and V-set and Ig domain-containing protein 2 (VSIG2) were the top-performing indicators linked with acute tubular injury and interstitial fibrosis/tubular atrophy, respectively. Thirty proteins were linked to kidney disease development, while 35 were linked to mortality. Placental growth factor (hazard ratio per doubling, 5.4; 95% CI, 3.4 to 8.7) and BMP and activin membrane-bound inhibitor (hazard ratio, 3.0; 95% CI, 2.1 to 4.2) were the best markers for kidney disease progression; TNF-related apoptosis-inducing ligand receptor-2 (hazard ratio, 2.9; 95% CI, 2.0 to 4.0) and CUB domain-containing protein-1 were the best markers (hazard ratio, 2.4; 95% CI, 1.8 to 3.3). Several plasma protein indicators were shown to be linked with kidney disease histology and poor clinical outcomes in people with a variety of kidney disorders.