Detecting Kidney Damage Before Hypertension Turns Into Kidney Failure

Mariia Dolinna, an accomplished nephrologist and clinical researcher with more than a decade of clinical and academic work in kidney disease, has developed a biomarker-based method that can help physicians detect hypertension-related kidney damage

Chronic kidney disease is now a top-ten global cause of death, yet much of its burden still accumulates before patients reach specialist care, according to recent Global Burden of Disease estimates.

Addressing this growing burden requires expertise that bridges research and real-world clinical practice. Mariia Dolinna, MD, PhD, a Ukrainian nephrologist and associate professor at Zaporizhzhia State Medical and Pharmaceutical University, combines academic work with hands-on experience in a hospital. Unlike many clinicians who rely primarily on standard kidney function indicators, she has developed a patented biomarker-based diagnostic approach. She has influenced international research as a reviewer for the European Journal of Medical Research, Scientific Reports, and the Ukrainian Journal of Nephrology and Dialysis and as a conference speaker across Belarus, Kazakhstan, Georgia, and Ukraine. This makes her perspective especially relevant as most patients remain unaware of kidney disease until it reaches advanced stages. 

The risk is most acute in patients already carrying known drivers of kidney damage. According to the Centers for Disease Control and Prevention’s 2026 estimates, more than one in five United States adults with high blood pressure also has chronic kidney disease. For nephrologists, that overlap makes hypertension-related kidney injury a revealing test case for the broader detection problem: patients may have reassuring routine laboratory results while kidney injury is already developing and the window for prevention begins to close. 

Mariia Dolinna encountered this problem both as a clinician and as an academic. As a nephrologist in the nephrology department of Zaporizhzhia Regional Clinical Hospital, she worked within a major clinical training base for Zaporizhzhia State Medical and Pharmaceutical University, a leading institution of higher education in Ukraine. She later advanced from assistant to associate professor and focused on developing methodological materials and physician education. “Standard evaluation usually relies on glomerular filtration rate and urinary albumin. These indicators are essential, but they do not always give clinicians a sufficiently detailed picture of the underlying kidney injury process,” she explains. “Earlier detection gives physicians a better chance to place patients under monitoring and begin nephroprotective treatment before kidney damage becomes harder to control,” she goes on. 

In developing the Method for Diagnosing Kidney Damage in Patients with Hypertensive Disease, Mariia aimed to make the standard kidney assessment more informative:

“Measures such as glomerular filtration rate and urinary albumin remain essential, but they show only part of the renal injury process,” she explains. “I wanted to broaden this diagnostic profile by adding neutrophil gelatinase-associated lipocalin and interleukin-18 in both blood serum and urine. These markers may respond earlier. A patient’s routine indicators can still look reassuring, while NGAL and IL-18 already suggest that morphologic kidney damage is developing.” 

Glomerular filtration rate and albuminuria remain central to nephrology practice, but they do not always capture the full morphological picture of renal injury. By adding neutrophil gelatinase-associated lipocalin and interleukin-18 in both blood serum and urine, her approach allows physicians to look beyond kidney function alone and assess whether tissue injury may already be present. For patients with hypertensive disease, that broader profile can support an earlier shift from delayed reaction to closer monitoring and nephroprotective treatment.

The original method rests on a broader view of hypertensive kidney injury. A normal glomerular filtration rate does not always reliably reflect whether morphologic kidney damage has already begun. By pairing functional measures with biomarkers linked to kidney injury, Mariia’s approach gives physicians a more detailed diagnostic profile, whether early morphological signs warrant closer monitoring and intervention. Hence, in Ukraine, it was introduced into nephrology, cardiology, and therapeutic hospital departments and incorporated into university teaching.

For Mariia Dolinna, the approach belongs to a longer scientific arc that began at Zaporizhzhia State Medical University, where she completed and defended her dissertation for the degree of Candidate of Medical Sciences in internal medicine. The research addressed a practical problem in nephrology: how to improve the diagnosis and treatment of damage to the glomerular apparatus and tubulointerstitial kidney tissue in patients with hypertension and chronic glomerulonephritis. That focus later carried into her patented method, built around the same clinical aim, identifying kidney damage while there is still time to change the patient’s trajectory. 

“When I began this research, hypertension and chronic glomerulonephritis were already deeply concerning nephrologists because of their prevalence, severe complications, and close link to chronic renal failure. I decided to focus on a more accurate assessment of damage to the glomerular apparatus and tubulointerstitial tissue so that kidney injury could be recognized earlier and treatment could begin before the disease limited the patient’s options,” she recalls. 

Nephrology, cardiology, and therapeutic departments in Ukrainian hospitals introduced Dolinna’s patented method into clinical work, while university departments incorporated it into the educational process. Mariia also presented related findings at professional scientific medical conferences in Belarus, Kazakhstan, Georgia, and Ukraine, with abstracts published in conference proceedings. Her topics included kidney injury markers in evaluating the nephroprotective effect of ramipril and clinical-morphological features of glomerular disease with arterial hypertension. 

In clinical practice, one of the main challenges remains the silent progression of chronic kidney disease, especially among patients with hypertension. Mariia Dolinna’s approach responds to this problem and gives physicians a more detailed way to see signs of kidney injury. Routine assessment remains necessary, but her biomarker-based approach adds evidence of morphologic kidney damage that may allow doctors to follow high-risk patients earlier, adjust monitoring more carefully, and begin nephroprotective treatment before kidney damage progresses toward failure. For a field where earlier recognition can change the direction of care, Mariia Dolinna’s work represents a notable contribution to preventive nephrology.