Kidney Injury Molecule-1 Level is Associated with the Severity of Renal Interstitial Injury and Prognosis in Adult Henoch–Schönlein Purpura Nephritis

Zhang, Yuanyuan; Li, Aiju; Wen, Jiliang; Zhen, Junhui; Hao, Qiufa; Zhang, Yidan; Hu, Zhao; Xiao, Xiaoyan

doi:10.1016/j.arcmed.2017.10.005

Cited by 13 publications

(13 citation statements)

References 29 publications

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“…A previous study showed that KIM-1 expression in tissue correlated well with tubulointerstitial nephritis features in different chronic kidney diseases, such as IgA nephropathy, kidney transplants, and adult Henoch-Schonlein purpura nephritis [10,11,20]. This result was also confirmed in ATI by this study.…”

Section: Discussionsupporting

confidence: 84%

Kidney injury molecule-1 expression predicts structural damage and outcome in histological acute tubular injury

et al. 2019

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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.

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Section: Discussionsupporting

confidence: 84%

Kidney injury molecule-1 expression predicts structural damage and outcome in histological acute tubular injury

et al. 2019

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“…uKIM-1 correlated with indices for TI inflammation, chronic TI change, and crescents. uKIM-1/Cr predicted decline of renal function in followup better than UACR [27]. In 69 nephrotic patients with MN and normal eGFR followed for a median of 39 months, the urine KIM-1 excretion rate was a good predictor of renal functional outcome and proteinuria remission, but it was not more accurate than other tubular markers including NGAL, α1-macroglobulin, or β 2macroglobulin [28].…”

Section: Discussion/conclusionmentioning

confidence: 84%

Kidney Injury Molecule-1 and Periostin Urinary Excretion and Tissue Expression Levels and Association with Glomerular Disease Outcomes

Troost

Dai

et al. 2021

Glomerular Dis

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Introductions: Kidney injury molecule-1 (KIM-1) and periostin (POSTN) are proximal and distal tubule injury biomarkers. We tested whether baseline urine KIM-1/Cr (uKIM-1/Cr) and/or uPOSTN/Cr correlated with disease severity or improved a remission prediction model. Methods: Baseline uKIM-1/Cr and uPOSTN/Cr were measured on spot urine samples from immunosuppression-free patients enrolled in Nephrotic Syndrome Study Network until December 15, 2014. Urine protein/Cr (UPCR) and albumin/Cr (UACR) were measured at baseline, 4 months, and until last follow-up. Glomerular and tubulointerstitial (TI) expression arrays were analyzed from a baseline research renal biopsy core collected during a clinically indicated biopsy. Renal diagnoses were centrally confirmed, sections scanned, and measured morphometrically. Correlations between baseline uKIM-1/Cr and uPOSTN/Cr and UPCR, UACR, histopathologic features, glomerular and TI KIM-1 and POSTN expression levels, and renal outcomes were assessed. Results: Baseline uKIM-1/cr correlated with UPCR and UACR and were associated with complete remission (CR) after adjustment for proteinuria, histopathologic diagnosis, and treatment. Baseline uKIM-1/Cr also correlated with degree of foot process effacement and acute tubular injury. Glomerular and TI KIM-1 expression levels correlated with UPCR and UACR. Higher TI KIM-1 expression levels correlated with interstitial fibrosis, tubular atrophy, and global glomerulosclerosis, while glomerular KIM-1 expression correlated with time to remission. Findings for POSTN were of lesser statistical strength. Discussion/Conclusion: Lower baseline uKIM-1/Cr values were associated with more rapid time to CR after adjusting for proteinuria, histopathologic diagnosis, and treatment. Increased TI KIM-1 expression levels in proteinuric states were associated with chronic morphological injury; lower glomerular expression levels were associated with a greater potential for proteinuria reversibility.

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“…Unlike our conclusions, Zhang et al and Zhang and colleagues confirmed the diagnostic value of urinary KIM-1 for detecting kidney injury in IgAV patients. 8,9 In the first study conducted on children, urinary KIM-1 levels were considerably higher in the IgAV-N group than in the IgAV-noN group. Moreover, they manifested a positive correlation with total urinary protein and histopathological grade assessed in accordance with International Study for Kidney Disease in Children classification.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, they manifested a positive correlation with total urinary protein and histopathological grade assessed in accordance with International Study for Kidney Disease in Children classification. 8 In the second research conducted on adult IgAV patients, concentrations of KIM-1 in urine were associated with interstitial inflammation, tubulointerstitial chronicity TA B L E 4 Logistic regression analysis in univariate model of the association of clinical characteristics, selected biochemical parameters, concentration of examined biomarkers and renal involvement in the course of immunoglobulin A vasculitis and extracapillary glomerular activity indices, which allowed the authors to conclude that the measurement of urinary KIM-1 level might be contributory in the evaluation of the severity and progression of renal damage in patients with IgAV-N. 9 Du et al have gone a step further in their analysis, indicating that the expression of NGAL and KIM-1 in serum, urine and renal tissues of children with IgAV-N and coexisting AKI was significantly higher than in the group with IgAV-N and nephrotic-range proteinuria. 10 This research also implied that urine NGAL and KIM-1 concentrations were negatively correlated with eGFR.…”

Section: Discussionmentioning

confidence: 99%

“…Encouraged by recently published promising reports presenting the value of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in distinguishing patients with IgAVN [6][7][8][9][10] as well as manuscripts on the role of the liver-fatty acid binding protein (L-FABP) as a novel biomarker of kidney injury, [11][12][13] we decided to evaluate their concentrations in children with IgAV.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of the association between kidney injury biomarkers concentration and nephritis in immunoglobulin A vasculitis: A pediatric cohort study

2020

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Objective The aim of this study was to investigate the clinical course, selected biochemical parameters and concentrations of renal injury biomarkers such as neutrophil gelatinase‐associated lipocalin (NGAL), kidney injury molecule‐1 (KIM‐1) and liver‐fatty acid binding protein (L‐FABP) in patients with immunoglobulin A vasculitis (IgAV) to identify the markers associated with nephritis in the course of the disease (IgAVN). Methods The study involved 29 children with IgAV and 34 healthy controls. Eleven (38%) patients had renal involvement (IgAV‐N) and 18 (62%) did not exhibit nephritis (IgAV‐noN). Initial laboratory tests, determining the concentrations of NGAL, KIM‐1 and L‐FABP in serum and urine, were conducted on children from the study group in an acute phase of IgAV as well as after an average of 6 months, during a follow‐up visit. The interconnection between renal involvement, anthropometric measurements, epidemiological data, laboratory parameters and levels of examined biomarkers have been thoroughly evaluated. Results The serum and urine levels of NGAL, KIM‐1 and L‐FABP were significantly higher in children with an acute phase of IgAV as compared to the control group (P < .001) and markedly lower during follow‐up retesting in comparison with the values obtained at inclusion (P < .001). However, the concentration of none of the evaluated biomarkers correlated with nephrological indices. Among all examined parameters, only male subjects were associated with nephritis (P = .017). Conclusions We have established no evident association between the concentrations of NGAL, KIM‐1 and L‐FABP and nephritis in the course of IgAV in children. Additionally, we confirmed a significant male predominance in patients with nephritis.

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Kidney Injury Molecule-1 Level is Associated with the Severity of Renal Interstitial Injury and Prognosis in Adult Henoch–Schönlein Purpura Nephritis

Cited by 13 publications

References 29 publications

Kidney injury molecule-1 expression predicts structural damage and outcome in histological acute tubular injury

Kidney injury molecule-1 expression predicts structural damage and outcome in histological acute tubular injury

Kidney Injury Molecule-1 and Periostin Urinary Excretion and Tissue Expression Levels and Association with Glomerular Disease Outcomes

Analysis of the association between kidney injury biomarkers concentration and nephritis in immunoglobulin A vasculitis: A pediatric cohort study

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