(Vienna, 13 August 2026) – A research team involving the Medical University of Vienna and the Institute of Molecular Biotechnology (IMBA) of the Austrian Academy of Sciences has identified three proteins in urine that could contribute to the non-invasive detection of clear cell renal cell carcinoma in the future. Using these three biomarkers, the scientists developed a so-called ‘UrineScore’, which was able to distinguish patients with this most common form of kidney cancer from healthy control subjects with a high degree of accuracy. The results, published in the journal EMBO Molecular Medicine, represent an important step towards an easily accessible, urine-based diagnostic test.
Clear cell renal cell carcinoma (ccRCC) accounts for around 80 per cent of renal cell carcinomas. To date, no established molecular biomarkers are available for rapid, non-invasive screening. The disease is therefore often discovered incidentally during imaging examinations or is only diagnosed once symptoms have already appeared, often at a late stage when survival rates are considerably lower.
For the current study, the research team analysed urine samples using a multi-omics approach. This involved a comprehensive analysis of proteins, lipids and metabolites. The investigations revealed characteristic changes in metabolism in patients with clear cell renal cell carcinoma, including alterations in lipid metabolism and mitochondrial metabolic activity.
Three proteins make up the ‘UrineScore’
The differences were particularly pronounced for three proteins: serum amyloid A1 (SAA1), haptoglobin (HP) and lipocalin 15 (LCN15). All three were elevated in the urine of patients with clear cell renal cell carcinoma. To enable these markers to be determined specifically and rapidly, the researchers developed a mass spectrometric method and combined the measurement results for the three proteins into a single diagnostic value, the ‘UrineScore’.
“With the UrineScore, we were able to combine three proteins measurable in urine into a single signature that has demonstrated high diagnostic specificity in two independent cohorts,” says last author Josef Penninger from MedUni Vienna. “Urine is easy to collect and non-invasive. This makes such biomarkers particularly interesting for future diagnostic applications,” adds first author Gustav Jonsson, who carried out the project at MedUni Vienna and IMBA and is now conducting postdoctoral research at the Medical University of Graz.
Larger clinical trials as the next step
The results mark an important step towards an easily accessible, urine-based diagnostic test. However, further investigations are necessary before it can be used in routine clinical practice. In particular, the UrineScore must be validated in larger and clinically representative groups of patients. This includes people with benign kidney changes, other urological conditions or inflammatory diseases that could affect the concentration of individual proteins in the urine.
The method currently in use is based on targeted mass spectrometry, as is available at academic medical centres. In principle, however, the identified proteins could also form the basis for simpler antibody-based testing methods. Further studies are needed to determine whether this can lead, in the long term, to the development of a urine test suitable for screening or clinical diagnosis.
The study was conducted with the participation of the Institute of Laboratory Medicine and the Department of Urology at MedUni Vienna, the IMBA of the Austrian Academy of Sciences, and international collaborators, including the Ramón y Cajal University Hospital in Madrid.
Publication: EMBO Molecular Medicine
Urinary multi-omics reveal non-invasive diagnostic biomarkers in clear cell renal cell carcinoma.
Gustav Jonsson, Tiago Oliveira, Maura Hofmann, Ursula Lemberger, Karel Stejskal, Gabriela Krššáková, Irma Sakic, Maria Novatchkova, Stefan Mereiter, Gerlinde Grabmann, Thomas Köcher, Rubina Koglgruber, Zeljko Kikic, Sonia Camano Páez, Bárbara Luna Sanchez, Víctor Díez Nicolás, Gerald N Rechberger, Thomas Züllig, Astrid Hagelkruys, Bernhard Englinger, Manuela Schmidinger & Josef M Penninger
EMBO Molecular Medicine, published online 11 August 2026.
https://link.springer.com/article/10.1038/s44321-026-00498-2