Laboratory Biomarkers for Early Screening of Metabolic Kidney Disease Risk in Older Adults

Abstract

  Background: Population aging and the increasing prevalence of metabolic disorders have substantially increased the burden of chronic kidney disease (CKD) among older adults. Because metabolic kidney disease develops gradually and often remains asymptomatic during its early stages, early identification using laboratory biomarkers has become an important strategy for preventing disease progression. Objective: This review aimed to summarize current evidence regarding conventional and emerging laboratory biomarkers for the early screening of metabolic kidney disease risk in older adults and to discuss the clinical value of an integrated multimarker approach for risk stratification and preventive nephrology. Methods: A narrative review was conducted by synthesizing recent evidence from peer-reviewed literature on laboratory biomarkers associated with metabolic kidney disease. Conventional biomarkers, including glycemic, lipid, renal, inflammatory, metabolic, and hematological parameters, as well as selected novel renal biomarkers, were evaluated with emphasis on their biological rationale, clinical applicability, and limitations. Results: Individual laboratory biomarkers reflect different stages of the pathophysiological continuum from metabolic dysregulation to subclinical kidney injury. Glycemic and lipid biomarkers identify upstream metabolic abnormalities, inflammatory and hematological biomarkers indicate systemic immune activation and oxidative stress, whereas renal biomarkers reflect structural and functional kidney impairment. Evidence suggests that integrating these routinely available laboratory biomarkers provides better risk stratification than single-marker assessment and may facilitate earlier identification of high-risk older adults before clinically overt CKD develops. Conclusion: An integrated laboratory biomarker approach represents a practical, accessible, and promising strategy for early screening of metabolic kidney disease in older adults. Incorporating multimarker assessment into primary healthcare, geriatric services, and routine medical check-up programs may improve early risk prediction, support personalized preventive interventions, and advance the implementation of predictive, preventive, and precision nephrology.