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Analyte
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Analyte Description
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Damaged Kidney Region
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Albumin
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Approximately 99% of filtered albumin is reabsorbed in the proximal tubule of kidney nephrons. In pathological conditions when glomerular capillary wall permeability and/or filtration rate increase, albumin excretion in urine increases. Detection of increased urinary albumin is of particular importance in the study of incipient renal disease. Higher levels of urinary albumin are also associated with cardiovascular disease in individuals with diabetes or hypertension.
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Proximal tubule
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B2M
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Beta-2-microglobulin is a protein found on the surface of all nucleated cells and is shed into the blood. Due to its small size, it passes through the glomerular membrane, but normally less than 1% is excreted due to reabsorption in the proximal tubules of the kidney. Elevated urine levels are an early biomarker of acute drug-induced glomerular damage and result in impairment of kidney tubular reabsorption.
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Glomerulus
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Calbindin
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Calbindins are calcium-binding proteins belonging to the troponin C superfamily. Calbindin D-28K is found predominantly in subpopulations of central and peripheral nervous system neurons, in epithelial cells involved in Ca2+ transport, such as distal tubular cells and cortical collecting tubules of the kidney, and in enteric neuroendocrine cells.
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Distal tubule, collecting duct
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Clusterin
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Clusterin (also known as ApoJ) is a highly conserved protein expressed in apoptotic heart, brain, lung, liver, kidney, and other tissues. Urinary clusterin is an early biomarker of acute drug-induced tubular damage and is more sensitive and specific than serum creatinine (SCr) or blood urea nitrogen (BUN) in monitoring renal function after exposure to nephrotoxicants.
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Proximal tubule, distal tubule
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Cystatin C
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Cystatin C is a 13 kDa protease inhibitor with high levels of expression in testis, epididymis, prostate, seminal vesicle, and vascular wall smooth muscle cells. Urine cystatin C is an early biomarker of acute drug-induced glomerular alterations or damage resulting from impairment of kidney tubular reabsorption.
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Glomerulus
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GST-π
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The glutathione S-transferase (GST) superfamily comprises cytosolic dimeric isoenzymes of 45–55 kDa in size. GST-π is located in the distal tubule and urinary levels are increased with distal tubule damage and can be indicative of renal transplant rejection, kidney infection, diabetes, and chronic renal injury.
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Distal tubule
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IL-18
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Interleukin-18 is a proinflammatory cytokine that induces interferon-gamma production in T cells and natural killer cells. Elevated urinary levels are an early marker of acute kidney injury (AKI), chronic renal insufficiency, endotoxemia, cancer chemotherapeutic toxicity, allograft rejection, and ischemia-reperfusion injury, and are an independent predictor of mortality in critically ill patients.
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Proximal and distal tubule
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KIM-1
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Kidney injury molecule-1 (also known as TIM-1) is an immunoglobulin superfamily cell surface protein that is highly upregulated on the surface of injured kidney epithelial cells and is localized predominantly to the apical membrane of the surviving proximal epithelial cells.
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Proximal tubule
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MCP-1
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Monocyte chemotactic protein-1 plays a role in the recruitment of monocytes to sites of injury and infection. MPC-1 is elevated in the urine of people with lupus as a warning sign of inflammation of the kidney. There is a close association between albuminuria, urinary MCP-1, and interstitial macrophage infiltration with progression of renal injury before the establishment of advanced renal scarring.
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Proximal tubule
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NGAL
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Neutrophil gelatinase-associated lipocalin (also known as lipocalin-2) is a small protein found not only in neutrophils but also in certain epithelia, such as renal tubules, where its expression is dramatically increased in ischemic or nephrotoxic injury. NGAL levels rise in urine and blood within 2 hours of renal insult, making NGAL a biomarker for acute renal injury.
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Proximal tubule
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OPN
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Osteopontin is a cytokine involved in the Th1 immune response that is secreted by a variety of tissues upon injury. It is present in human urine at levels that can effectively inhibit calcium oxalate crystallization. Low concentrations of OPN have been documented in urine from patients with renal stone disease compared to normal individuals.
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Proximal tubule, loop of Henle, distal tubule, collecting duct
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TFF3
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Trefoil factor 3 exists as monomeric (6.7 kDa) and dimeric (13.1 kDa) forms expressed by goblet cells of the intestine and the colon, and in the human respiratory tract, promoting survival and differentiation of epithelial cells. TFF3 may show reduced urine excretion in response to acute kidney injury. Higher urinary levels may indicate ongoing kidney repair and increased risk for chronic kidney disease (CKD)
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Proximal tubule
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