Kidney injury molecule 1 (KIM-1): a potential biomarker of acute kidney injury and tubulointerstitial injury in patients with ANCA-glomerulonephritis

Abstract

Background Kidney injury molecule 1 (KIM-1) is a transmembrane glycoprotein expressed by proximal tubular cells, recognized as an early, sensitive, and specific urinary biomarker for kidney injury. Blood KIM-1 was recently associated with the severity of acute and chronic kidney damage but its value in ANCA-associated vasculitis with glomerulonephritis (ANCA-GN) has not been studied. Thus, we analyzed its expression at ANCA-GN diagnosis and its relationship with clinical presentation, kidney histopathology, and early outcomes. Methods We assessed KIM-1 levels and other pro-inflammatory molecules (CRP, IL-6, TNF-α, MCP-1 and PTX3) at ANCA-GN diagnosis and after 6 months in patients included in the Maine-Anjou registry, which gathers data patients from four French Nephrology Centers diagnosed since January 2000. Results Blood KIM-1 levels were assessed in 54 patients. Levels were elevated at diagnosis and decreased after induction remission therapy. KIM-1 was associated with the severity of renal injury at diagnosis and the need for KRT. In opposition to other pro-inflammatory molecules, KIM-1 correlated with the amount of acute tubular necrosis and interstitial fibrosis/tubular atrophy (IF/TA) on kidney biopsy, but not with interstitial infiltrate nor with glomerular involvement. In multivariable analysis, elevated KIM-1 predicted initial eGFR (β = -19 [-31, -7.6], p = 0.002). Conclusion KIM-1 appears as a potential biomarker for acute kidney injury and for tubulointerstitial injury in ANCA-GN. Whether KIM-1 is only a surrogate marker or a key immune player in ANCA-GN pathogenesis remain to be determined.

The Nephroprotective Effect of Cornelian Cherry (Cornus mas L.) and Rowanberry (Sorbus aucuparia L.) in Gentamicin-Induced Nephrotoxicity on Wistar Rats with Emphasis on the Evaluation of Novel Renal Biomarkers and the Antioxidant Capacity in Correlation with Nitro-Oxidative Stress

“…Lately, increased blood levels of KIM-1 have been linked to both acute and chronic kidney injury. This biomarker has proven to be a remarkable indicator of renal damage in rat experimental models, surpassing BUN and creatinine as predictors of histopathological changes in the proximal tubules [54]. In the current study, KIM-1 levels significantly increased in the gentamicintreated rats due to the occurrence of renal impairment, whereas administration of both extracts substantially decreased its levels.…”

Deceased Kidney Donor Biomarkers: Relationship between Delayed Kidney Function and Graft Function Three Years after Transplantation

“…uKIM-1 is recognized as an early and specific urinary biomarker for kidney injury and has been tested in many AKI studies [34]. There are a small number of studies that have tested blood KIM-1 in kidney disease [35,36]. Recently, a small study analyzed the diagnostic performance of serum and urine KIM-1 in renal donors and recipients to predict DGF.…”