Abstract: Chronic kidney disease (CKD) has become a public health challenge worldwide and is closely associated with the risk of cardiovascular and other adverse events. How to identify the occurrence and progression of CKD early, stratify the risk of the population, and give early prevention and treatment is the focus of clinical attention. Metabolomics, a non-invasive, high-throughput assay elucidates the pathophysiological mechanisms of diseases by quantitative or semi-quantitative analysis of the abundance of metabolites and the metabolic pathways involved. Studies indicate that the metabolome of CKD patients can show significant differences with deteriorating renal function, and a variety of metabolites are closely associated with the deterioration of renal function, the risk of cardiovascular events, and even the risk of all-cause mortality in patients. Metabolomics has been successfully applied to improve the assessment of GFR and explore novel biomarkers for the risk of CKD and its complications. Furthermore, the application of metabolomics expands the understanding of the underlying pathophysiologic mechanisms of various complications during CKD and strengthens the understanding of the interactions of gut microbiome and their metabolites with CKD. This article reviews the research progression and application of metabolomics in CKD to provide novel directions for clinical diagnosis and treatment.

Key words: chronic kidney disease, metabolomics, biomarker