New Biomarker Panel Improves Assessment of Pediatric Chronic Kidney Disease

Pediatric chronic kidney disease (CKD) is a serious condition that can advance to kidney failure, requiring dialysis or transplantation. Given the high mortality rates associated with kidney failure in children, clinicians urgently need better tools to predict which patients are most at risk of disease progression. Now, researchers have identified a biomarker panel that significantly improves the ability to assess CKD progression in children, supporting better clinical monitoring and more precise enrollment in clinical trials.

The panel was developed by researchers at Yale School of Medicine (New Haven, CT, USA) who were involved in the Chronic Kidney Disease (CKD) Biomarkers Consortium, building on previous work to identify markers of kidney tubule health, injury, dysfunction, and inflammation. The latest study was conducted through the Chronic Kidney Disease in Children (CKiD) Cohort Study and involved over 500 children aged six months to sixteen years. To develop the panel, the researchers measured biomarkers in both plasma and urine samples and applied regression tree–based statistical modeling to determine the most informative predictors of disease progression. This modeling technique allowed them to identify a combination of markers that together offer more accurate prognostic insights than current standard measures alone.

Image: A new biomarker panel can significantly improve the prediction of CKD progression (Photo courtesy of Adobe Stock)

The final biomarker panel included four key indicators: urine albumin/creatinine ratio, urine epidermal growth factor/creatinine ratio, plasma kidney injury molecule-1, and estimated glomerular filtration rate (eGFR). These biomarkers emerged as the most predictive for identifying children at the highest risk of CKD progression. In clinical practice, this panel offers substantial practical advantages. For children and their families, having a clearer understanding of disease progression risk allows for tailored management. Those at higher risk can adopt proactive preventative strategies, while those at lower risk may be able to reduce the frequency of medical visits, helping preserve critical childhood experiences and reducing unnecessary disruptions to daily life.

“While current clinical biomarkers only partially capture the variability of CKD progression, this research demonstrates that a combination of biomarkers which represent key pathways of kidney health can significantly improve risk prediction,” said Yale researcher Jason Greenberg, MD, MHS, who led the study. “This research could help physicians with clinical monitoring and treatment strategies for individual patients, potentially slowing disease progression and improving long-term outcomes.”