Dear Colleagues,

In the nephrological field, we are waiting for new biomarkers to fill the void caused by serum creatinine and urine output, characterized by low sensitivity and specificity, to detect renal damage early on. In recent decades, several studies have improved the knowledge surrounding the physiopathology of several renal diseases, with a better diagnosis and therapeutic management of acute (AKI) and chronic kidney diseases (CKD). AKI, as part of sepsis and related to a high mortality rate, is appropriately treated if precociously revealed. In this context, several biomarkers have been proposed, such as neutrophil gelatinase-associated lipocalin (NGAL) or the product of the two G1 cell-cycle inhibitors: tissue inhibitor metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7); however, further studies must validate these biomarkers for their use in the clinical practice. Moreover, a precocious detection of AKI is the starting point for preventing the transition from AKI to chronic damage, which is now becoming evident both in clinical and experimental settings, with an irreversible loss of organ function. Inflammation, tubule-interstitial injury, and fibrosis are the main processes characterizing this condition, and a better understanding of these mechanisms associated with the discovery of blood and urinary AKI-to-CKD biomarkers could improve the early identification of AKI patients with a higher risk of CKD progression, representing a new challenge for nephrologists. Recently, new therapeutic strategies involving CKD patients, such as sodium/glucose cotransporter-2 inhibitors (SGLT2i) and mineralocorticoid receptor (MR) antagonists, act not only at renal levels on tubular dysfunction and fibrosis but also on the well-known cross-talk between the kidney and distant organs, such as the heart. Renal prognostic biomarkers, revealing the effects of these drugs, could improve the personalization of the treatment and its outcomes.

This Special Issue aims to present original research (e.g., randomized controlled trials, cohort studies), literature reviews, and meta-analyses, to improve our understanding of renal biomarkers in acute, subacute, and chronic diseases.

Dr. Paolo Monardo
Guest Editor

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• renal biomarkers
• acute kidney injury
• chronic kidney disease
• liquid kidney biopsy
• renal omics
• cardio-renal syndrome
• AKI-CKD transition
• tubulo-interstitial injury