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Kidney tissue transcriptomic categories of CKD, defined by distinct patterns of inflammatory, metabolic and fibrotic pathway activation and linked to non-invasive urine classifiers, provide a framework to enrich early-stage trials with patients who harbour the molecular processes targeted by a given agent and to monitor on-target pathway modulation ( 7 Summary and future perspective Multi-omics technologies have expanded the biomarker repertoire for early-stage chronic kidney diseasehere referring largely to KDIGO G1G2 and selected G3a categories with preserved eGFR but evidence of kidney damage, including normoalbuminuric phenotypesbeyond albuminuria and estimated glomerular filtration rate by capturing pathophysiological processes such as tubular stress, inflammation, fibrosis and metabolic dysregulation at high resolution (Saliba et al., 2024