Urinary KIM-1: a novel biomarker for evaluation of occupational exposure to lead

Abstract

Chronic occult lead poisoning often develops ensuing occupational lead exposure. Early diagnosis of lead poisoning is critical for timely discontinuation of lead exposure and for prognosis. This study explored the value of urinary kidney injury molecule-1 (KIM-1) in diagnosing renal injury induced by lead at an early stage. We retrospectively analyzed 92 workers exposed to occupational lead and demonstrated a better correlation ship between blood lead levels and urine excretion of KIM-1 than other traditional renal injury biomarkers following creatinine adjustment. Receiver operating characteristic curve analysis of the ability of diverse biomarkers for predicting kidney injury in lead-exposed workers demonstrated that the order of predicting accuracy of the studied biomarkers is as follows: urinary KIM-1-to-creatinine ratio > urinary N-acetyl-β-(D)-glucosaminidase-to-creatinine ratio > urinary β2-microglobulin-to-creatinine ratio > urinary α1-microglobulin-to-creatinine ratio, with the Youden index being 16.59 ng/g, 14.01 U/g, 0.15 mg/g, and 4.63 mg/g, respectively. Collectively, our findings suggest that short-period occupational lead exposure may cause injury of renal tubules. Urinary excretion of KIM-1 correlates with blood lead levels better than other traditional renal injury biomarkers, including N-acetyl-β-(D)-glucosaminidase, α1-microglobulin, and β2-microglobulin. Longitudinal surveillance of urinary KIM-1 may aid for early diagnosis of renal tubular injury in workers with occupational lead exposure.

Novel urinary biomarkers and their association with urinary heavy metals in chronic kidney disease of unknown aetiology in Sri Lanka: a pilot study

“…In our study, there was no significant difference between the mean UAs concentrations between the three groups, but the levels were higher than the US population data indicating possible exposure. Both seafood and rice can contribute to elevated UAs levels [27][28][29][30]. In the present study, we did not gather information about the sea fish intake of the participants.…”

“…Rice cultivators can accumulate both inorganic and organic forms of arsenic. The proportion of inorganic arsenic in rice grain differs according to the variety [29,30]. Urinary Pb levels were significantly higher in farmer controls than CKDu patients and non-farmer controls.…”

“…However, our study did not find any correlation between KIM-1 and β2-microglobulin and urinary Cd levels. In lead exposed workers, urinary excretion of KIM-1 was shown to correlate with blood lead levels better than other renal injury biomarkers, including NGAL, α1-microglobulin, and β2-microglobulin [30]. Urinary biomarkers have not been used to evaluate arsenic induced nephrotoxicity.…”

Chronic Kidney Disease and Exposure to Nephrotoxic Metals

“…Similarly, a cross-sectional study of Korean adults demonstrated a positive correlation between blood Pb levels and renal dysfunction [ 270 ]. Additionally, erythrocyte Pb appears to be associated with renal injury [ 271 ].…”

Lala clam (Orbicularia orbiculata) shell as an eco-friendly adsorbent for Cd(II), Cu(II) and Pb(II) ions

“…For instance, high level of copper in water environment particularly in drinking water may cause Wilson's disease, which leads to accumulation of copper in tissues such as the liver and brain, thus leading to liver disease as well as psychiatric and neurological symptoms to human (Stock, Reuner, Gohll, & Beste, 2016). In addition, it has been reported that lead exposure was accounted for about 853,000 deaths in 2013 due to long-term effects on health, with the highest number of cases in low and middle-income countries (Zhou et al, 2016). Many industrial processes involve heavy metals as important components for electrical appliances.…”