Background: Discovery of the ideal biomarker for clinical care remains a major challenge. Recent progress in genomic and proteomic technologies has allowed the identification of thousands of potential markers, although the benefits of these findings in clinical routine use are not completely evident yet. Methods: Major genomics and proteomics approaches are outlined and their clinical applications are described. Future developments in clinical nephrology are discussed. Conclusion: Genomics and proteomics technologies, used to measure gene expression at the transcript and at the protein levels, provide complementary information, which paves the way for systems biology. The fields of genomics and proteomics continue to develop rapidly, and it is evident that there is great potential for their ability to predict diseases and outcomes. However, there are several tasks that must be accomplished to convert all these ‘-omics' approaches into clinical practice. Collaboration between clinicians, scientists and healthcare funding organizations together with specific guideline development and high-throughput analytical automation will be crucial to reach the final potential of these technologies.

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