The biomarkers commonly utilized in diagnostic evaluations of kidney disease suffer from low sensitivity, especially in the early stages of renal damage. On the other hand, obtaining a renal biopsy to augment clinical decision making can lead to potentially serious complications. In order to overcome the shortcomings of currently available diagnostic tools, recent studies suggest that exosomes, cell-secreted extracellular vesicles containing a large array of active molecules to facilitate cell-to-cell communication, may represent a rich source of novel disease biomarkers. Because of their endocytic origin, exosomes carry markers typical for their parent cells, which could permit the localization of biochemical cellular alterations in specific kidney compartments. Different types of exosomes can be isolated from noninvasively obtained biofluids; however, in the context of kidney disease, evidence has emerged on the role of urinary exosomes in the diagnostic and predictive modeling of renal pathology. The current review summarizes the potential application of exosomes in the detection of acute and chronic inflammatory, metabolic, degenerative, and genetic renal diseases.

中文翻译：

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肾病中的外泌体：新型生物标志物的丰富来源。

通常在肾脏疾病的诊断评估中使用的生物标记物灵敏度低，尤其是在肾脏损害的早期阶段。另一方面，进行肾脏活检以增强临床决策可能会导致潜在的严重并发症。为了克服当前可用的诊断工具的缺点，最近的研究表明，外泌体是细胞分泌的细胞外囊泡，其中含有大量的活性分子以促进细胞间的交流，可能代表了新型疾病生物标志物的丰富来源。由于它们的内吞起源，外来体带有其亲代细胞典型的标志物，这可能使生化细胞改变位于特定的肾区室中。可以从非侵入性获得的生物流体中分离出不同类型的外泌体。然而，在肾脏疾病的背景下，有关泌尿外泌体在肾脏病理诊断和预测模型中的作用的证据已经出现。目前的综述总结了外泌体在检测急性和慢性炎症，代谢，变性和遗传性肾脏疾病中的潜在应用。