Revolutionizing early chronic kidney disease detection: the potential of kidney functional reserve and biomarker integration

Abstract

This paper focuses on the importance of early diagnosis of chronic kidney disease (CKD) before the development of prob- lems that are used to diagnose the disease currently, especially in high-risk patients with diabetes mellitus, obesity, and hypertension. The main diagnosis of CKD depends on the glomerular filtration rate (GFR) values. However, GFR values remain insufficient to detect diagnosis until the near-last stages of the disease because of the kidney’s intrinsic compensa- tion mechanism. The kidney can normally not use nephrons at full power, but in such conditions as the initial stages of CKD, it can increase the power of filtration on nephrons to compensate for the body’s needs. However, this increase occurs at a single nephron level and does not reflect the GFR level until the near-last stages of CKD. With current technology, there is no usable method to calculate the single nephron filtration rate. The concept of kidney functional reserve (KFR) helps to understand the situation of the kidney at a single nephron. Also, the integration of cystatin C and creatinine for calcula- tions increases precision. The proposed method mentioned in this paper can revolutionize the early detection of CKD and enhance the prognosis of the disease. Clinical trials are recommended to validate the reliability of KFR in CKD diagnosis and treatment strategies based on KFR assessments. This approach proposes a great potential for improving early diagnosis, prognosis, and life quality of individuals at risk of CKD.