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QJM Advance Access originally published online on June 24, 2009
QJM 2009 102(8):523-538; doi:10.1093/qjmed/hcp071
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© The Author 2009. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The non-invasive biopsy—will urinary proteomics make the renal tissue biopsy redundant?

K. Bramham1, H.D. Mistry1, L. Poston1, L.C. Chappell1 and A.J. Thompson2

From the 1Maternal and Fetal Research Unit and 2MRC Centre for Neurodegeneration Research, King's College, London, UK

Address correspondence to Dr K. Bramham, MRCP, Maternal and Fetal Research Unit, KCL Division of Reproduction and Endocrinology, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK. email: kate.bramham{at}kcl.ac.uk


  Abstract

Proteomics is a rapidly advancing technique which gives functional insight into gene expression in living organisms. Urine is an ideal medium for study as it is readily available, easily obtained and less complex than other bodily fluids. Considerable progress has been made over the last 5 years in the study of urinary proteomics as a diagnostic tool for renal disease. Advantages over the traditional renal biopsy include accessibility, safety, the possibility of serial sampling and the potential for non-invasive prognostic and diagnostic monitoring of disease and an individual's response to treatment. Urinary proteomics is now moving from a discovery phase in small studies to a validation phase in much larger numbers of patients with renal disease. Whilst there are still some limitations in methodology, which are assessed in this review, the possibility of urinary proteomics replacing the invasive tissue biopsy for diagnosis of renal disease is becoming an increasingly realistic option.


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