Urinary
peptides gained significant attention as potential
biomarkers especially in the context of kidney and
cardiovascular disease. In this manuscript the recent literature since 2015 on urinary
peptide investigation in human kidney and
cardiovascular disease is reviewed. The technology most commonly used in this context is capillary electrophoresis coupled mass spectrometry, in part owed to the large database available and the well-defined dataspace. Several studies based on over 1000 subjects are reported in the recent past, especially examining CKD273, a classifier for assessment of
chronic kidney disease based on 273 urine
peptides. Interestingly, the most abundant urinary
peptides are generally
collagen fragments, which may have gone undetected for some time as they are typically modified via
proline hydroxylation. The data available suggest that urinary
peptides specifically depict
inflammation and
fibrosis, and may serve as a non-invasive tool to assess
fibrosis, which appears to be a key driver in kidney and
cardiovascular disease. The recent successful completion of the first urinary
peptide guided intervention trial, PRIORITY, is expected to further spur clinical application of urinary peptidomics, aiming especially at early detection of
chronic diseases, prediction of progression, and prognosis of drug response.