The Marker of Tubular Injury, Kidney Injury Molecule-1 (KIM-1), in Acute Kidney Injury Complicating Acute Pancreatitis: A Preliminary Study

Abstract

Acute pancreatitis (AP) may be associated with severe inflammation and hypovolemia leading to organ complications including acute kidney injury (AKI). According to current guidelines, AKI diagnosis is based on dynamic increase in serum creatinine, however, creatinine increase may be influenced by nonrenal factor and appears late following kidney injury. Kidney injury molecule-1 (KIM-1) is a promising marker of renal tubular injury and it has not been studied in AP. Our aim was to assess if urinary KIM-1 may be used to diagnose AKI complicating the early stage of AP. We recruited 69 patients with mild to severe AP admitted to a secondary care hospital during the first 24 h from initial symptoms of AP. KIM-1 was measured in urine samples collected on the day of admission and two subsequent days of hospital stay. AKI was diagnosed based on creatinine increase according to Kidney Disease: Improving Global Outcomes 2012 guidelines. Urinary KIM-1 on study days 1 to 3 was not significantly higher in 10 patients who developed AKI as compared to those without AKI and did not correlate with serum creatinine or urea. On days 2 and 3, urinary KIM-1 correlated positively with urinary liver-type fatty acid-binding protein, another marker of tubular injury. On days 2 and 3, urinary KIM-1 was higher among patients with systemic inflammatory response syndrome, and several correlations between KIM-1 and inflammatory markers (procalcitonin, urokinase-type plasminogen activator receptor, C-reactive protein) were observed on days 1 to 3. With a limited number of patients, our study cannot exclude the diagnostic utility of KIM-1 in AP, however, our results do not support it. We hypothesize that the increase of KIM-1 in AKI complicating AP lasts a short time, and it may only be observed with more frequent monitoring of the marker. Moreover, urinary KIM-1 concentrations in AP are associated with inflammation severity.

Zengye Decoction Attenuated Severe Acute Pancreatitis Complicated with Acute Kidney Injury by Modulating the Gut Microbiome and Serum Amino Acid Metabolome

“…Therefore, the changes in Cr and BUN in this study were slight and insignificant. One preliminary study proved the diagnostic value of urinary KIM-1 concentration for SAP-AKI patients, which showed the shortcomings like lasting a short time and the need for frequent monitoring [ 52 ]. A rare study explored the serum KIM-1 value for SAP-AKI severity assessment [ 51 ].…”

Features of Acute Coronary Syndrome in Combination with Oncological Diseases in Elderly and Senile Patients

“…Корреляции уровней KIM-1 с креатинином и рСКФ в нашей работе не выявлены, что согласуется с результатами ретроспективного исследования Wajda J., с соавт. (2020) [16]. Вероятно, это может быть связано с тем, что KIM-1 является маркером, отражающим преимущественно повреждение проксимальных канальцев [2].…”

“…У пациентов с ОПП (n=29), в отличие от больных без ОПП (n=58) был выявлен более высокий уровень KIM-1 (999,2 (480,8;1314,1) и 663,1 (360,5;905,2) пг/мл; р=0,008), что согласуется с данными литературы [2,10,16]. Кроме того, у них была выше альбуминурия (62,0 (11,4; По данным литературы, гиперурикемия, и, как следствие, гиперурикурия может развиваться при прогрессировании ОЗ, проведении химио-и/или лучевой терапии [4,5].…”

Pankreatitisbedingte akute Nierenschädigung (AP-AKI): Definition, Pathophysiologie, Diagnostik und Therapie

“…In zwei bisher publizierten Metaanalysen mit über 2900 eingeschlossenen Erwachsenen und 1620 eingeschlossenen Kindern konnten diese Ergebnisse bestätigt werden [116,117]. Zum aktuellen Zeitpunkt existiert nur eine retrospektive Studie mit 69 eingeschlossenen Patienten, die die diagnostische Aussagekraft von KIM-1 im Rahmen einer AP untersuchte [118]. Zwar konnte KIM-1 mit der Schwere des Entzündungsprozesses der AP korreliert werden, jedoch konnte kein Unterschied der KIM-1-Urinkonzentration zwischen der AKI-und der Non-AKI-Gruppe festgestellt werden.…”