Modern markers for determining the functional ability of the kidneys in urological practice

Introduction. Over the past decade, there has been a progressive increase in the number of patients with chronic kidney disease (CKD). Early diagnosis of renal insufficiency allows to prevent irreversible consequences leading to disability and significant medical and economic costs. Purpose: to analyze modern markers for determining the functional ability of the kidneys. Materials and methods. A search was carried out in PubMed and Library, according to the keywords creatinine, urea, glomerular filtration rate (GFR), clearance, formulas for calculating creatinine clearance, cystatin C, β2-microglobulin, в-bound protein, NGAL, KIM-1, chronic kidney disease, chronic renal failure, urolithiasis. We found 389 sources no older than 10 years (published after 2012) that were relevant to the topic of the review. 80 articles were selected directly for citation in the review. Results. GFR assessment and detection of albuminuria are the most effective methods, but biomarkers used to calculate GFR are subject to a number of factors and do not allow assessing kidney function in real time. For early prediction of acute renal injury, the most suitable biomarkers are considered to be: NGAL and KIM-1 and IL-18. Equations combining cystatin C and creatinine r work better than equations using only cystatin C or creatinine, especially in situations where it is necessary to confirm chronic kidney disease. The combination of creatinine, cystatin C and the ratio of urine albumin to creatinine improves the stratification of the risk of progression of kidney disease and mortality. The latest developments in biomarkers allow us to hope that in the near future the assessment of the functional ability of the kidneys will be carried out in real time and will become a general clinical practice of a modern doctor. Conclusion. Modern biomarkers of the functional ability of the kidneys allow not only to evaluate the function, but also to screen for diseases, conduct differential diagnosis, and evaluate the effectiveness of the treatment. The modern approach to the diagnosis of renal dysfunction should be based not only on its diagnosis, but also on determining the topic of nephron damage.