The significance of KIM-1 、CC16 in acute kidney injury and acute lung injure

Abstract

Objectives To investigate the change of kidney injury molecule 1 (KIM-1) and Clara cell secretion protein(CCSWCC16) in the patients with acute kidney injury(AKI) and acute lung injury(ALI),and study the significance of acute kidney/lung injury.Methods A study was conducted in 25 pure AKI patients,15 pure ALI patients,25 AKI and ALI patients,and 23 non-smoking controls (age,race,and gender-matched).ELISA method to detect urinary KIM-1 、plasma KIM-1 、urinary CC16 and plasma CC16; colorimetric method to detect urinary N-acetyl-beta-D-glucosaminidase(NAG).Results Campa~d with non-smoking control group,the urinary NAG 、urinary KIM-1 、plasma KIM-1 and plasma CC16 values were significantly increased in AKI group(P ＜0.05) ; the urinary CC16 and plasma CC16 values were significantly increased in ALI group (P ＜0.05) ;the urinary NAG、urinary KIM-1 、plasma KIM-1 、urinary CC16 and plasma CC16 values were significantly increased in AKI and ALI group(P ＜ 0.05).Correlation analysis showed:In AKI patients,urinary KIM-1 was positive correlated with urinary NAG (r =0.493,P ＜0.01),while the plasma KIM-1 was no correlated with urinary NAG.In ALI patients,urinary CC16 was negative correlated with oxygenation index,the same as plasma CC16(P ＜0.01).In AKI and ALI group,urinary KIM-1 、plasma KIM-1were positive associated with urinary CC16 and plasma CC16 respectively (P ＜ 0.05).3.Receiver operator characteristic curve (ROC) analysis showed:In AKI,the area under the curve (AUC) of urinary KIM-1 was 0.781 (95 ％ CI 0.688 ～ 0.875,P ＜ 0.01) ; plasma KIM-1 was 0.988 (95％ CI 0.000 ～ 1.000,P ＜ 0.01) ; urinary NAG was 0.798 (95％ CI 0.708 ～ 0.888,P ＜ 0.01).In ALI,the AUC of urinary CC 16 was 1.000 (95 ％ CI 1.000 ～ 1.000,P ＜ 0.01) ; plasma CC 16 was 0.849 (95 ％ CI 0.764 ～ 0.935,P ＜ 0.01).Conclusions Urinary NAG,urinary KIM-1 and plasma KIM-1 were obviously increased in AKI,showed that these indicators can be used to early diagnose AKI.Urinary CC16 and plasma CC16 were significantly elevated in ALI,and with high sensitivity,suggested that CC16 can serve as a good biomarker for ALI.Urinary and plasma KIM-1 and CC16 were significantly increased in acute kidney/lung injury and with good correlation,showed that KIM-1,CC16 have clinical significance for diagnosis and prognosis of acute kidney/lung injury. Key words: Kidney ; Lung; Proteins