Detection comes too late
Conventional tests often identify kidney dysfunction only after significant, irreversible damage.
Redefining kidney function diagnostics.
A new dimension of kidney function, from a single urine sample.
Chronic kidney disease affects more than 800 million people worldwide, yet today's standard tests often detect kidney dysfunction too late. Equilibrium Diagnostics has developed a fast, low-cost urine test that uncovers tubular dysfunction before conventional markers change.
Earlier detection. Better risk stratification. Fewer patients progressing to end-stage kidney disease.
The Challenge
Why current kidney diagnostics fall short
CKD costs healthcare systems over €1 trillion annually, and affects more than one in ten adults globally. But the tools used to detect it (eGFR and albuminuria) measure only two dimensions of kidney function, and often not until damage is advanced.
Glomerular function isn't enough
Current diagnostics focus on filtration (eGFR) and barrier integrity (albuminuria). Tubular function, a critical new dimension, is overlooked, leaving clinicians without a full view of the kidney.
Dialysis is often avoidable
Many CKD patients progress to kidney failure because early tubular dysfunction goes unnoticed. Catching it earlier can delay or prevent end-stage disease, and the enormous human and financial cost that follows.
Our Solution
A new dimension of kidney assessment
The urine Ammonium–pH Index (uAPI) is a new measure that quantifies renal tubular function: the kidney's ability to manage acid–base balance. A single urine sample, analysed on our AP Reader, produces the uAPI: a clear early-warning signal that conventional tests cannot capture.
Filtration Capacity
eGFR — Glomerular filtration rate
Barrier Integrity
UACR — Albuminuria
Tubular Function NEW
uAPI — urine Ammonium-pH Index
How it works
A fast, affordable diagnostic workflow
The uAPI integrates seamlessly into existing clinical pathways. A single urine sample is all that is needed — no invasive procedures, no specialist equipment. Results deliver a new layer of clinical intelligence alongside standard kidney markers.
Urine Sample
A routine, non-invasive urine sample collected at the clinic — no additional patient burden.
AP Reader
The AP Reader measures urinary ammonium and pH with gold-standard potentiometric precision.
uAPI Score
The patented algorithm converts raw measurements into a single, clinically meaningful score.
Clinical Decision
Clinicians receive actionable risk stratification to guide referrals, treatment, and monitoring.
The Product
An in-vitro diagnostic built for the clinic
The AP Reader is an automated in-vitro diagnostic analyser designed to integrate seamlessly into research and clinical laboratory workflows. Robust, low-maintenance measurements with high accuracy in clinically relevant concentration ranges.
Purpose-built for research labs today
The AP Reader is the hardware entry point: an automated analyser that takes a standard urine sample and returns uAPI.
Research-Backed
A Danish medtech venture, built on a decade of research
The uAPI isn't a hypothesis. It's the result of years of research at Aarhus University and validation across thousands of patient samples in international studies and clinical research collaborations.
>7×
Higher risk of kidney failure1
In matched CKD Stage 3–4 patients with the same age, sex, BMI, eGFR, uACR, blood pressure and diabetes status, a low uAPI predicts a more than 7-fold higher risk of a serious kidney event.
>60%
Net reclassification improvement
Adding the uAPI to standard clinical variables (age, sex, BMI, eGFR, uACR, diabetes status, and systolic blood pressure) reclassifies >60% of patients into a more accurate risk category.
Health System Impact
A measurable case for earlier detection
An independent 2025 health-economic study by the Nordic Institute of Health Economics modelled the impact of adding the uAPI to the KDIGO framework for CKD risk stratification and referral.
€75M
Annual savings in Denmark
From adoption of the uAPI in CKD risk stratification and referral optimisation across the Danish CKD population of 242,729 patients.
€8–10B+
Annual savings across the EU
Extrapolated from Danish data across EU member states, using KDIGO vs KDIGO + uAPI modelling. Dialysis and transplant costs excluded, so the true figure is likely higher.
CKD at a glance
Chronic kidney disease – four key insights
Why it matters, and why early detection is so difficult.
CKD is typically asymptomatic until late stages. The kidneys compensate for declining function for years, and patients often learn they have advanced disease only when symptoms finally appear. By that point, intervention options are limited. More than one in ten adults globally is living with CKD; many are undiagnosed.
Today's standard-of-care tests measure filtration (eGFR) and the glomerular barrier (UACR). But the kidney has essential tubular functions that these tests don't assess. In many cases, damage to the tubules often precedes damage to the glomerulus, which is why the uAPI is synergistic rather than competing.
CKD costs global healthcare systems over €1 trillion per year. End-stage kidney failure requires dialysis (multiple sessions per week, indefinitely) or transplant. The human cost is higher: diminished quality of life, cardiovascular complications, shortened lifespan. A significant portion of these outcomes is avoidable with earlier intervention.
New therapies (SGLT2 inhibitors, GLP-1 receptor agonists, non-steroidal mineralocorticoid receptor antagonists) slow or even reverse CKD progression. They work best when started early. The bottleneck is no longer treatment; it's detection. That is the gap the uAPI is built to close.
Beyond Chronic Kidney Disease
Expanding Indications
Renal tubular acid handling is a highly relevant measure whenever acid-base regulation is under stress. Research into new indications is ongoing, with the goal of bringing precise acid-base diagnostics to more patients across multiple disease areas.
Cystic Fibrosis
Cystic fibrosis is caused by mutations in the CFTR anion channel. CFTR channel defects impair epithelial bicarbonate secretion and is an important part of the pathogenesis in the disease. CFTR dysfunction also impairs renal bicarbonate excretion. Urine acid-base profiling can help reveal the extent of channel dysfunction and whether CFTR modulators are achieving meaningful functional benefit, providing an objective, low-cost response marker to complement expensive therapies.
- Can help find the best treatment option for each patient
- Avoiding prolonged exposure to costly drugs with adverse effects is an important clinical task
Intestinal Failure
Patients with short bowel anatomy lose bicarbonate through the gut, generating a persistent acid load that routine serum labs often underestimate or even miss. Renal net acid excretion offers a physiologically grounded measure of the true metabolic burden.
- Quantifies true acid burden even when routine serum labs appear normal
- Guides accurate, individualised parenteral base supplementation
- May reduce costly complications (e.g. bone disease, muscle catabolism, kidney impairment, and hospitalisation)
Research Services
Comprehensive urine acid-base assessment
We offer comprehensive assessment of urine acid/base parameters and expert guidance regarding sample collection, storage, and interpretation on a case-by-case basis.
- Direct measurement of urine pH, ammonium, titratable acidity, and bicarbonate
- Calculation of the urine ammonium pH index (uAPI)
- Quantification of renal net acid concentration
- Evaluation of net endogenous acid production — relevant for dietary studies or any research where acid-base balance is of interest
- Quantification of kidney tubular function across a broad range of diseases and interventions
- Early detection of metabolic perturbations — the uAPI may be sensitive before changes in GFR or albuminuria are detectable
About Us
A Danish medtech venture, built on a decade of kidney research
Equilibrium Diagnostics is a research-based venture spun out of Aarhus University, headquartered at the BioInnovation Institute in Copenhagen. We are developing a new diagnostic infrastructure for chronic kidney disease, grounded in more than ten years of foundational research in renal physiology, and built in close collaboration with the clinicians who will use it.
Get in Touch
Ready to redefine diagnostics?
Whether you're a clinician, an investor, an IVD partner, or a researcher, we would love to hear from you.