Pathology of Chronic Kidney Disease and Spatial Metabolomics

Chronic kidney disease (CKD) has diverse etiologies but exhibits common features in presentation and progression. These include glomerular sclerosis, tubular atrophy, and interstitial fibrosis, often with inflammation and vascular rarefaction. Although these pathologic features have been described in CKD for decades, the molecular drivers of the disease process remain poorly understood. In the era of multiomics and spatial biology, the spatial metabolomics platform could well be a critical technology to guide characterization of the shared cellular programs, capturing the important protective and destructive pathways that ultimately culminate in each of these pathologic features. In this review, we discuss the specific approaches and challenges to developing spatial metabolomics signatures for pathologic features in CKD.