Kidney Injury Molecule-1 and Cardiovascular Diseases: From Basic Science to Clinical Practice

Abstract

Despite the recent findings concerning pathogenesis and novel therapeutic strategies, cardiovascular disease (CVD) still stays the leading cause of morbidity and mortality in patients with renal dysfunction, especially acute kidney injury (AKI). Early detection of patients with impaired renal function with cardiovascular risk may help ensure more aggressive treatment and improve clinical outcome. Kidney injury molecule-1 (KIM-1) is a new, promising marker of kidney damage which is currently the focus of countless studies worldwide. Some recent animal and human studies established KIM-1 as an important marker of acute tubular necrosis (ATN) and reliable predictor of development and prognosis of AKI. Food and Drug Administration (FDA) in USA acclaimed KIM-1 as an AKI biomarker for preclinical drug development. Recent data suggest the importance of monitoring of KIM-1 for early diagnosis and clinical course not only in patients with various forms of AKI and other renal diseases but also in patients with cardiorenal syndrome, heart failure, cardiopulmonary bypass, cardiothoracic surgical interventions in the pediatric emergency setting, and so forth. The aim of this review article is to summarize the literature data concerning KIM-1 as a potential novel marker in the early diagnosis and prediction of clinical outcome of certain cardiovascular diseases.

Biomarkers of Inflammation, Fibrosis, and Acute Kidney Injury in Patients with Heart Failure with and without Left Ventricular Assist Device Implantation

“…In our study, KIM-1 levels were not significantly different among the groups. Although KIM-1 is a new, promising marker of kidney damage [26], some studies reported that KIM-1 levels are associated with glomerular filtration, but not with other urinary tubular damage markers [27, 28], and that the levels of KIM-1 differentiated poorly between patients with good or poor outcomes [28]. Other studies found that KIM-1 predicted the progression of kidney damage [29] or AKI in patients who underwent cardiac surgery [30].…”

Early Predictors of Acute Kidney Injury: A Narrative Review

“…For example, a study involving 62 patients undergoing renal transplant has shown that KIM-1 levels in kidney tissues were significantly elevated in all patients who developed AKI. For patients with acute rejection, the rate reached even 92% [47].However, there was no significant change in AKI patients with complicated nephrotic syndrome [44,48].…”

Biomarkers of acute kidney injury: the pathway from discovery to clinical adoption

“…Within the past 2 decades, a few novel potential biomarkers ( Table 1) that are measurable in urine or plasma of patients with AKI have been identified [49], including neutrophil gelatinase-associated lipocalin (NGAL) [17,50,51], kidney injury molecule 1 (KIM-1) [27,52], interleukin 18 (lL-18) [53], liver-type fatty acid-binding protein (L-FABP) [54], tissue inhibitor of metalloproteinase 2 (TlMP-2), insulin-like growth factorbinding protein 7 (IGFBP7) [33], calprotectin [42], urine angiotensinogen (AGT) [55], and urine microRNAs [47,56].…”

“…Studies investigating KIM-1 as a biomarker of AKI have shown variable results [27,52,98,99]. In patients with congestive heart failure, Damman et al recently demonstrated that KIM-1 is an outstanding predictive marker for AKI detection [100].…”