Clinical proteomics in kidney disease as an exponential technology: Heading towards the disruptive phase

Exponential technologies double in power or processing speed every year, whereas their cost halves. Deception and disruption are two key stages in the development of exponential technologies. Deception occurs when, after initial introduction, technologies are dismissed as irrelevant, while they continue to progress, perhaps not as fast or with so many immediate practical applications as initially thought. Twenty years after the first publications, clinical proteomics is still not available in most hospitals and some clinicians have felt deception at unfulfilled promises. However, there are indications that clinical proteomics may be entering the disruptive phase, where, once refined, technologies disrupt established industries or procedures. In this regard, recent manuscripts in CKJ illustrate how proteomics is entering the clinical realm, with applications ranging from the identification of amyloid proteins in the pathology lab, to a new generation of urinary biomarkers for chronic kidney disease (CKD) assessment and outcome prediction. Indeed, one such panel of urinary peptidomics biomarkers, CKD273, recently received a Food and Drug Administration letter of support, the first ever in the CKD field. In addition, a must-read resource providing information on kidney disease-related proteomics and systems biology databases and how to access and use them in clinical decision-making was also recently published in CKJ.Grant support was received from: ISCIII and FEDER funds PI13/00047; EUTOX, CP12/03262, CP14/00133, PI15/00298, PI14/00386, PI15/01460, PI16/01900, PI16/02057; Diabetes Cancer Connect PIE13/00051; Sociedad Española de Nefrologia; FRIAT; and ISCIII-RETIC REDinREN RD016/009. Salary support was received from: ISCIII Miguel Servet to A.B.S., A.M.R. and M.D.S.-N.; Joan Rodes to B.F.-F; and Programa Intensificación Actividad Investigadora (ISCIII/Agencia Laín-Entralgo/CM) to A.O