Up Front MattersExtracellular Vesicles in Renal Diseases More than Novel Biomarkers?Erdbrügger, Uta; Le, Thu H. Author Information Department of Medicine, Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia Correspondence: Dr. Uta Erdbrügger, Department of Medicine, Division of Nephrology, University of Virginia Health System, PO Box 800133, Charlottesville, VA 22903. Email: [email protected] Journal of the American Society of Nephrology 27(1):p 12-26, January 2016. | DOI: 10.1681/ASN.2015010074 Buy Metrics Abstract Extracellular vesicles from the urine and circulation have gained significant interest as potential diagnostic biomarkers in renal diseases. Urinary extracellular vesicles contain proteins from all sections of the nephron, whereas most studied circulating extracellular vesicles are derived from platelets, immune cells, and the endothelium. In addition to their diagnostic role as markers of kidney and vascular damage, extracellular vesicles may have functional significance in renal health and disease by facilitating communication between cells and protecting against kidney injury and bacterial infection in the urinary tract. However, the current understanding of extracellular vesicles has derived mostly from studies with very small numbers of patients or in vitro data. Moreover, accurate assessment of these vesicles remains a challenge, in part because of a lack of consensus in the methodologies to measure extracellular vesicles and the inability of most techniques to capture the entire size range of these vesicles. However, newer techniques and standardized protocols to improve the detection of extracellular vesicles are in development. A clearer understanding of the composition and biology of extracellular vesicles will provide insights into their pathophysiologic, diagnostic, and therapeutic roles. Copyright © 2016 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.