Cell-free DNA as a plausible biomarker of chronic kidney disease

Epigenomics. 2023 Sep;15(17):879-890. doi: 10.2217/epi-2023-0255. Epub 2023 Oct 4.

Abstract

Circulating cell-free DNA (cf-DNA) is released from dead and/or apoptotic leukocytes and due to neutrophil extracellular traps contributing to an inflammatory response. Previous clinical studies have reported that the peak concentrations and dynamic changes of cf-DNA may be used as a noninvasive biomarker of worsening kidney function as well as a guide to the management of kidney allograft rejection. We hypothesized that the pattern and dynamic changes of cf-DNA might be a plausible predictive biomarker for patients at risk of chronic kidney disease (CKD), including individuals with type 2 diabetes mellitus, heart failure, cardiovascular disease and established CKD. Along with it, pre- and posthemodialysis levels of serum cf-DNA appear to be a independent predictor for all-cause mortality in patients with end-stage kidney disease.

Keywords: biomarkers; cell-free DNA; chronic kidney disease; clinical decision-making; end-stage kidney disease; kidney allograft rejection; kidney failure; kidney injury.

Plain language summary

What is this article about? The article focuses a new view on the risk of kidney function worsening and relating complications based on measurements of circulating fragments of DNA (called nucleotides). What were the results? The results showed that a measure of circulating fragments of DNA may detect both the risk of occurrence and the progression of chronic kidney disease in certain patient populations. What do the results of the study mean? The study indicates that a strategy of single and serial measurements of circulating DNA fragments is likely to be effective for personalized management of patients with chronic kidney disease, including those on dialysis and after kidney transplantation.

Publication types

  • Review

MeSH terms

  • Biomarkers
  • Cell-Free Nucleic Acids*
  • DNA
  • Diabetes Mellitus, Type 2*
  • Disease Progression
  • Humans
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / genetics

Substances

  • Cell-Free Nucleic Acids
  • Biomarkers
  • DNA