**Author details**

**Markers**

**11. Conclusion**

**Acute kidney injury (AKI); Acute graft rejection (AGR); Acute tubular necrosis (ATN)**

76 Current Issues and Future Direction in Kidney Transplantation

**Chronic allograft nephropathy (CAN/ IFTA); Delayed graft function (DGF)**

CTGF + Yue et al., 2010; Bao et al., 2008

uPA + Alachkar , 2012 Leukocyte elastase (LE) + + Zynek-Litwin et al., 2010 SERPING1 + Ling et al., 2010 TIMP1 + Ling et al., 2010 MIP-1delta, + + Hu et al., 2009 Osteoprotegerin + + Hu et al., 2009

VEGF + Peng et al., 2008 fractalkine + Peng et al., 2008

Perforin + Oberbauer, 2008 FOXP3 + Oberbauer, 2008

In this chapter we presented traditional and new biomarkers for diagnostics and monitoring condition of transplant kidneys. Urine is practical, easy to obtain, noninvasive material for diagnosis of kidney diseases. Numerous reports from molecular biology, genetics, proteomics and metabolomics disclosed an array of new markers specifically connected with damage of specific nephron segments in the course of successive steps of disease. Particular expectations are connected with proteins represented particular nephron section, or produced locally in the place of nephron damage. Presence of cytokines and chemokines in urine is an early sign of renal inflammatory state, due to influx of granulocytes to the damaged nephron area. Majority of traditional biomarkers, particularly enzymuria retains diagnostic value in an evaluation of the renal tubules function. Multitude of presented biomarkers suggest their limited diagnostic value. Discovering universal marker seems to be very difficult. However, it is potentially more fruitful to identity the putative biomarker proteins useful in diagnostics of kidney disease.

**Table 1.** Urinary biomarkers for the early detection of acute and chronic allograft dysfunction.

MCP-1 + Dubiński et al., 2008; Urbschat et al., 2011 RBP + Kuźniar et al., 2006; Câmara et al., 2009

OX40,OX40L,PD-1 + Afaneh et al., 2010 HLA-DR + Ting et al., 2010

**References**

Alina Kępka<sup>1</sup> , Napoleon Waszkiewicz2 , Sylwia Chojnowska3 , Beata Zalewska-Szajda4 , Jerzy Robert Ładny<sup>5</sup> , Anna Wasilewska6 , Krzysztof Zwierz7 and Sławomir Dariusz Szajda<sup>5</sup>

1 The Children's Memorial Health Institute, Warsaw, Poland

2 Department of Psychiatry, Medical University, Białystok, Poland

3 Medical Institute, College of Computer Science and Business Administration, Łomża, Po‐ land

4 Department of Radiology, Children Hospital, Medical University of Białystok, Poland

5 Department of Emergency Medicine and Disasters, Medical University, Białystok, Poland

6 Department of Pediatric Nephrology, Medical University of Białystok, Poland

7 Medical College the Universal Education Society, Łomża, Poland
