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.
Highlights
Acute kidney injury (AKI) is a common clinical syndrome with a poor prognosis [1]
Based on the pathology assessment of acute tubular injury (ATI), 13 of the 27 ATI patients were in the mild ATI group, and 14 patients were in the severe ATI group
The level of Kidney injury molecule-1 (KIM-1) was negatively related to eGFR, and ROC curve analysis revealed that the ROC-AUC was 0.923 (p 1⁄4 0.000) for the diagnosis of ATI based on a combination of high urinary kidney injury molecule-1 (uKIM-1) and sKIM-1 levels
Summary
Acute kidney injury (AKI) is a common clinical syndrome with a poor prognosis [1]. the sCr-based AKI definition provides little information on actual renal dysfunction, which prevents the timely estimation of the severity of the renal injury and administration of possible therapeutic agents [2,3]. Several studies have shown that the expression level of KIM-1 in renal tissue (tKIM-1) could predict the prognosis of various chronic kidney diseases, such as IgA nephropathy, and kidney transplants [10–13]. A few studies have shown that urinary kidney injury molecule-1 (uKIM-1) levels are increased in acute kidney injury (AKI); 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. 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. Combining uKIM-1 and sKIM-1 can increase the sensitivity and specificity of the diagnosis of severe ATI
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