Use of urine biomarkers for determining the risk of subjects having subclinical acidosis

A method for monitoring the development of subclinical acidosis (SA) in a subject suffering from chronic kidney disease (CKD), the method comprising

• determining a first score based on a relationship between the levels of at least two biomarkers selected from the group consisting of NH4+ vs. pH, NH4+ vs. titratable acid (TA), NH4+ vs. total base (TB), NH4+ vs. base buffers (BB), and/or NH4+ vs. HCO3−, said biomarkers being measured or sensed in a first urine sample from the subject;
• determining a second score based on a relationship between the levels of at least two biomarkers selected from the group consisting of NH4+ vs. pH, NH4+ vs. titratable acid (TA), NH4+ vs. total base (TB), NH4+ vs. base buffers (BB), and/or NH4+ vs. HCO3−, said biomarkers being measured or sensed in a second urine sample from the subject, wherein the second sample has been obtained at a later time point than the first sample;
• comparing corresponding scores in the first and second sample;
• wherein
• a negative score in the second sample compared to a positive score in the first sample is indicative of development of subclinical acidosis;
• a positive score in the second sample compared to positive score in the first sample is indicative of no development of subclinical acidosis;
• a negative score in the second sample compared to a negative score in the first sample is indicative of maintained subclinical acidosis;
• a positive score in the second sample compared to negative score in the first sample is indicative of improved/lessening of subclinical acidosis.

A method for determining the effect of a treatment protocol against subclinical acidosis (SA) for a subject suffering from chronic kidney disease (CKD), the method comprising

• determining a first score based on a relationship between the levels of at least two biomarkers selected from the group consisting of NH4+ vs. pH, NH4+ vs. titratable acid (TA), NH4+ vs. total base (TB), NH4+ vs. base buffers (BB), and/or NH4+ vs. HCO3−, said biomarkers being measured or sensed in a first urine sample from the subject;
• determining a second score based on a relationship between the levels of at least two biomarkers selected from the group consisting of NH4+ vs. pH, NH4+ vs. titratable acid (TA), NH4+ vs. total base (TB), NH4+ vs. base buffers (BB), and/or NH4+ vs. HCO3−, said biomarkers being measured or sensed in a second urine sample from the subject, wherein the second sample has been obtained at a later time point than the first sample;
• wherein the treatment protocol has been initiated or completed before the sampling of the first sample or initiated, continued or completed between the sampling of the first and second sample,
• comparing scores of the first sample and the second sample;
• wherein
• a negative score in the second sample compared to a positive score in the first sample is indicative of the treatment protocol not being effective against subclinical acidosis;
• a negative score in the second sample compared to a negative score in the first sample is indicative of the treatment protocol not being effective against subclinical acidosis;
• a positive score in the second sample compared to negative score in the first sample is indicative of the treatment protocol being effective against subclinical acidosis.