Kidney injury molecule-1 expression predicts structural damage and outcome in histological acute tubular injury

Abstract

Background: A few studies have shown that urinary kidney injury molecule-1 (uKIM-1) levels are increased in acute kidney injury (AKI); however, the correlation between uKIM-1 and histological tubular injury, which is considered to be the gold standard for evaluating renal damage and predicting prognosis, is still unclear. We performed this study to determine whether the predicted value of uKIM-1 is correlated with renal KIM-1 (tKIM-1) expression and tissue damage in AKI patients. Methods: This retrospective study recruited 14 healthy individuals and 27 biopsy-proven acute tubular injury (ATI) patients. uKIM-1 and plasma KIM-1 (sKIM-1) levels were measured by ELISA, and tKIM-1 expression was evaluated by immunohistochemistry. Results: Elevated levels of urinary, plasma, and renal KIM-1 were found in ATI patients. The uKIM-1 concentration was positively correlated with tKIM-1 expression and reflected the severity of renal histological injury. The outcome of ATI was associated with uKIM-1 expression: the ATI patients with higher uKIM-1 levels had an increased potential for an incomplete recovery of renal function during follow-up. Additionally, the level of KIM-1, regardless of source, was negatively related to the eGFR, and ROC curve analysis revealed that the ROC-AUC was 0.923 ( p = 0.000) for the diagnosis of ATI based on a combination of high uKIM-1 and sKIM-1 levels. Conclusion: The uKIM-1 level corresponds with the severity of renal histological damage and can be a potential reliable predictor of adverse renal outcomes in ATI patients. Moreover, combining uKIM-1 and sKIM-1 can increase the sensitivity and specificity of the diagnosis of severe ATI.

Renal Glycosuria as a Novel Early Sign of Colistin-Induced Kidney Damage in Mice

“…6). The Kim-1 ROC AUC of 1.0 in this study is comparable to other findings (26, 39), whereas glycosuria shows an AUC of 0.93, showing that both markers have high sensitivity and specificity for colistin-induced AKI. The interesting finding that urinary Kim-1 levels did not correlate with urinary glucose in samples collected after 7 days of colistin treatment suggests that both markers can offer separate and equally relevant information on early renal injury.…”

“…Urinary Kim-1 levels have been assessed under colistin treatment in rats, with the report that it is a specific marker of proximal tubular damage (22), with very low expression in healthy kidney tissue (23, 24). Histology is the ideal gold standard for assessing tubular injury, although not always feasible, with Kim-1 representing an example where histological examination and urinary output of the marker have been shown to correlate closely both in rodents and humans (25, 26).…”

Nifedipine Exacerbates Lipogenesis in the Kidney via KIM-1, CD36, and SREBP Upregulation: Implications from an Animal Model for Human Study

“…Kidney fibrosis, a condition that causes impaired renal function, was increased in the DR+NF group but not in the HFD group. In an earlier literature review, uKIM-1 level correlated with the severity of renal histological damage, and can be a potential reliable predictor of adverse renal outcomes in acute tubular injury [ 25 ], and KIM-1 is a sensitive tissue indicator of AKI [ 26 ]. TNF-α, which causes inflammatory cell injury, can significantly induce the expression of the apo-A4 protein, which is also associated with pro-inflammatory acute kidney injury in human kidney cells [ 27 ].…”

Could KIM-1 and NGAL levels predict acute kidney injury after paracentesis? – preliminary study

“…In their another study, Belcher et al observed that multiple structural biomarkers of kidney injury were independently associated with progression of AKI and mortality in patients with cirrhosis, but their levels were similar to those without progression and those with progression alone [3]. Finally, Cai et al performed an observation that aimed to determine whether the predicted value of urine KIM-1 is correlated with renal KIM-1 expression and tissue damage in AKI patients [28]. The authors observed a close relationship between the severity of renal histological damage and the urine KIM-1 level.…”

“…Finally, Cai et al. performed an observation that aimed to determine whether the predicted value of urine KIM-1 is correlated with renal KIM-1 expression and tissue damage in AKI patients [ 28 ]. The authors observed a close relationship between the severity of renal histological damage and the urine KIM-1 level.…”