The value of kidney injury molecule 1 in predicting acute kidney injury in adult patients: a systematic review and Bayesian meta-analysis

Abstract

Introduction The aim of the study was to systematically review relevant studies to evaluate the diagnostic value of urinary kidney injury molecule 1 (uKIM-1) for acute kidney injury (AKI) in adults. Method We searched PubMed and Embase for literature published up to November 1st, 2019 and used the Quality Assessment Tool for Diagnosis Accuracy Studies (QUADAS-2) to assess the quality. Then, we extracted useful information from each eligible study and pooled sensitivity, specificity, and area under the curve (AUC) values. Results A total of 14 studies with 3300 patients were included. The estimated sensitivity of urinary KIM-1 (uKIM-1) in the diagnosis of AKI was 0.74 (95% CrI 0.62–0.84), and the specificity was 0.84 (95% CrI, 0.76–0.90). The pooled diagnostic odds ratio (DOR) was 15.22 (95% CrI, 6.74–42.20), the RD was 0.55 (95% CrI 0.43–0.70), and the AUC of uKIM-1 in diagnosing AKI was 0.62 (95% CrI 0.41–0.76). The results of the subgroup analysis showed the influence of different factors. Conclusion Urinary KIM-1 is a good predictor for AKI in adult patients with relatively high sensitivity and specificity. However, further research and clinical trials are still needed to confirm whether and how uKIM-1 can be commonly used in clinical diagnosis.

A Mixture of Pure, Isolated Polyphenols Worsens the Insulin Resistance and Induces Kidney and Liver Fibrosis Markers in Diet-Induced Obese Mice

“…Thus, an expression profile of fibrosis and kidney damage markers was conducted. Our results showed an upregulation of kidney injury molecule-1 (Kim-1) [ 42 ], and an upregulation in the mRNA levels of the transcription factor carbohydrate-responsive element-binding protein b (Chrebpb) , the increase of which has been related to the progression of diabetic kidneys ( Figure 5 a) [ 43 ]. In addition, an upward trend in the expression of fibronectin (Fn-1) , a protein related to fibrotic processes [ 44 , 45 ] was also detected.…”

Acute Kidney Injury: Biomarker-Guided Diagnosis and Management

“…Interleukin (IL)-18, a pro-inflammatory cytokine that induces the production of interferon gamma, is detected in urine after acute proximal tubular damage [ 10 , 22 ]. Urine KIM-1, a transmembrane glycoprotein, is a proven marker of AKI in adults [ 23 ]. NGAL is a key polypeptide found in blood and urine at the time of AKI development after ischemic or toxicity-induced damage in the kidney [ 24 ].…”

Advances in laboratory detection of acute kidney injury

“…For clinical practice, KIM-1 has been proposed as a biomarker of proximal tubule damage [ 43 ] for predicting AKI, diagnosing AKI, and estimating AKI severity [ 32 ]. A recent meta-analysis involving adult patients reported that KIM-1 was a good predictor of AKI, with an estimated sensitivity of 0.74 (95% credible interval, 0.62–0.84) and specificity of 0.86 (95% credible interval, 0.76–0.90) [ 84 ]. Elevated KIM-1 levels can be measured 12–24 h after tubular injury, peaking at 2–3 days [ 85 ].…”