COMPARATIVE ANALYSIS OF NOVEL EARLY BIOMARKERS FOR GFR ESTIMATION IN RENAL DISORDERS.

Abstract

Kidney diseases, including acute kidney injury (AKI) and chronic kidney disease (CKD), are prevalent and often asymptomatic in early stages, making early detection challenging. Traditional biomarkers such as serum creatinine and blood urea nitrogen (BUN) are limited in sensitivity for early renal dysfunction. Novel biomarkers like Cystatin-C (CYS-C), neutrophil gelatinase-associated lipocalin (NGAL), microalbumin, and C-reactive protein (CRP) may provide improved early detection and monitoring of kidney function.

Objective: This study aimed to comparatively analyze novel early biomarkers and conventional markers for estimating glomerular filtration rate (GFR) in patients with varying stages of renal disorders.

Methods: An observational descriptive study was conducted in the Department of Biochemistry, Shri Gorakshnath Medical College hospital and Research center, Gorakhpur, Uttar Pradesh from March to August 2025, A total of 190 subjects were included: 38 healthy controls, 38 chronic diabetes patients, 38 acute renal failure patients, 38 chronic renal failure patients, and 38 dialysis patients. Biomarkers analyzed included serum creatinine, BUN, calcium, phosphorus, CYS-C, NGAL, CRP, urine microalbumin, and estimated GFR using creatinine (eGFR/CRE) and Cystatin-C (eGFR/CYS-C). Statistical analysis included mean ± SD comparisons and correlation studies.

Results: Progressive deterioration of renal function was observed across the study groups. Conventional markers (serum creatinine, BUN) increased, while eGFR decreased with advancing kidney disease. Novel biomarkers, including CYS-C, NGAL, microalbumin, and CRP, showed strong positive correlation with serum creatinine and strong negative correlation with eGFR, highlighting their sensitivity in detecting both early and advanced renal impairment. Serum calcium decreased and phosphorus increased with disease progression. Diabetic patients exhibited significant hyperglycemia and early renal involvement.

Conclusion: Novel biomarkers such as Cystatin-C, NGAL, microalbumin, and CRP demonstrate superior sensitivity over traditional markers for early detection and monitoring of kidney dysfunction. Incorporation of these biomarkers into clinical practice may enable timely intervention and improve outcomes in patients with renal disorders.