Skip to main content
SpringerLink
Log in

Urinary kidney injury molecule-1: a novel biomarker to monitor renal function in patients with unilateral ureteral obstruction

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to investigate the clinical significance of urinary kidney injury molecule-1 (KIM-1) to monitor renal function in patients with obstructive unilateral ureteral calculi.

Methods

Kidneys of 12 male C57BL/6J mice, as well as their urine and plasma specimens, were extracted to detect KIM-1 expressions 24 h after unilateral ureteral obstruction (UUO) construction or sham surgery. Meanwhile, a cohort of 89 patients with unilateral ureteral calculi was retrospectively reviewed. 46 of which received double-J ureteral stent indwelling (group 1) and the remaining 43 were treated conservatively (group 2). Urinary KIM-1 levels in the baseline, 2 h and 1 day after treatments were analyzed.

Results

KIM-1 expressions were dramatically higher in mice underwent UUO surgery when compared with the sham group. Clinical data showed urinary KIM-1 levels decreased as time went by for patients in group 1 (1.787 ± 1.081 ng/mL for baseline, 1.668 ± 1.162 ng/mL for 2 h and 0.935 ± 0.526 ng/mL for 1 day after operation; p = 0.0001). Nevertheless, for those in group 2, a mild increase (1.659 ± 0.997 ng/mL, 1.691 ± 0.872 ng/mL and 1.675 ± 0.911 ng/mL, correspondingly; p = 0.9869) was observed. Additionally, a urinary KIM-1 value of 1.04 ng/mL had a sensitivity of 83.1% and specificity of 62.5% to predict the presence of hydronephrosis (95% CI: 0.641–0.873, AUC: 0.757, p < 0.001).

Conclusions

Urinary KIM-1 is a sensitive biomarker of post-renal acute kidney injury (AKI) and might predict the presence of hydronephrosis. It can be used as an effective surrogate to monitor renal function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kellum JA, Mehta RL, Levin A et al (2008) Development of a clinical research agenda for acute kidney injury using an international, interdisciplinary, three-step modified Delphi process. Clin J Am Soc Nephrol 3:887–894

    Article  Google Scholar 

  2. Kellum JA, Levin N, Bouman C et al (2002) Developing a consensus classification system for acute renal failure. Curr Opin Crit Care 8:509–514

    Article  Google Scholar 

  3. Koyner JL, Vaidya VS, Bennett MR et al (2010) Urinary biomarkers in the clinical prognosis and early detection of acute kidney injury. Clin J Am Soc Nephrol 5:2154–2165

    Article  CAS  Google Scholar 

  4. Wasilewska A, Taranta-Janusz K, Debek W et al (2011) KIM-1 and NGAL: new markers of obstructive nephropathy. Pediatr Nephrol 26:579–586

    Article  Google Scholar 

  5. Yang L, Brooks CR, Xiao S et al (2015) KIM-1-mediated phagocytosis reduces acute injury to the kidney. J Clin Invest 125:1620–1636

    Article  Google Scholar 

  6. Bonventre JV, Yang L (2011) Cellular pathophysiology of ischemic acute kidney injury. J Clin Invest 121:4210–4221

    Article  CAS  Google Scholar 

  7. Bonventre JV (2009) Kidney injury molecule-1 (KIM-1): a urinary biomarker and much more. Nephrol Dial Transplant 24:3265–3268

    Article  CAS  Google Scholar 

  8. Ichimura T, Hung CC, Yang SA et al (2004) Kidney injury molecule-1: a tissue and urinary biomarker for nephrotoxicant-induced renal injury. Am J Physiol Renal Physiol 286:F552–563

    Article  CAS  Google Scholar 

  9. Lim AI, Tang SC, Lai KN et al (2013) Kidney injury molecule-1: more than just an injury marker of tubular epithelial cells? J Cell Physiol 228:917–924

    Article  CAS  Google Scholar 

  10. Ichimura T, Bonventre JV, Bailly V et al (1998) Kidney injury molecule-1 (KIM-1), a putative epithelial cell adhesion molecule containing a novel immunoglobulin domain, is up-regulated in renal cells after injury. J Biol Chem 273:4135–4142

    Article  CAS  Google Scholar 

  11. Bonventre JV (2014) Kidney injury molecule-1: a translational journey. Trans Am Clin Climatol Assoc 125:293–299

    PubMed  PubMed Central  Google Scholar 

  12. van Timmeren MM, Bakker SJ, Vaidya VS et al (2006) Tubular kidney injury molecule-1 in protein-overload nephropathy. Am J Physiol Renal Physiol 291:F456–464

    Article  Google Scholar 

  13. Han WK, Bailly V, Abichandani R et al (2002) Kidney Injury Molecule-1 (KIM-1): a novel biomarker for human renal proximal tubule injury. Kidney Int 62:237–244

    Article  CAS  Google Scholar 

  14. Gohda T, Kamei N, Koshida T et al (2020) Circulating kidney injury molecule-1 as a biomarker of renal parameters in diabetic kidney disease. J Diabetes Investig 11:435–440

    Article  CAS  Google Scholar 

  15. Xie Y, Xue W, Shao X et al (2014) Analysis of a urinary biomarker panel for obstructive nephropathy and clinical outcomes. PLoS ONE 9:e112865

    Article  Google Scholar 

  16. Xue W, Xie Y, Wang Q et al (2014) Diagnostic performance of urinary kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin for acute kidney injury in an obstructive nephropathy patient. Nephrology (Carlton) 19:186–194

    Article  CAS  Google Scholar 

  17. Puri TS, Shakaib MI, Chang A et al (2010) Chronic kidney disease induced in mice by reversible unilateral ureteral obstruction is dependent on genetic background. Am J Physiol Renal Physiol 298:F1024–1032

    Article  CAS  Google Scholar 

  18. Qian S, Huang Y, Wang N et al (2019) Urinary neutrophil gelatinase-associated lipocalin as a biomarker to monitor renal function in patients with obstructive ureteral calculi. World J Urol 37:1197–1204

    Article  CAS  Google Scholar 

  19. Parikh CR, Butrymowicz I, Yu A et al (2014) Urine stability studies for novel biomarkers of acute kidney injury. Am J Kidney Dis 63:567–572

    Article  CAS  Google Scholar 

  20. Lewington AJ, Sayed A (2010) Acute kidney injury: how do we define it? Ann Clin Biochem 47:4–7

    Article  CAS  Google Scholar 

  21. Stevens PE, Tamimi NA, Al-Hasani MK et al (2001) Non-specialist management of acute renal failure. QJM 94:533–540

    Article  CAS  Google Scholar 

  22. Bellomo R, Ronco C, Kellum JA et al (2004) Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 8:R204–212

    Article  Google Scholar 

  23. Mehta RL, Kellum JA, Shah SV et al (2007) Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 11:R31

    Article  Google Scholar 

  24. Waikar SS, Betensky RA, Bonventre JV (2009) Creatinine as the gold standard for kidney injury biomarker studies? Nephrol Dial Transplant 24:3263–3265

    Article  CAS  Google Scholar 

  25. Herget-Rosenthal S, Marggraf G, Husing J et al (2004) Early detection of acute renal failure by serum cystatin C. Kidney Int 66:1115–1122

    Article  CAS  Google Scholar 

  26. American Society of Nephrology Renal Research Report (2005) J Am Soc Nephrol 16:1886–1903

    Article  Google Scholar 

  27. Katayama M, Miyazaki T, Ohata K, et al. Temporal changes in urinary excretion of liver-type fatty acid binding protein (L-FABP) in acute kidney injury model of domestic cats: a preliminary study. J Vet Med Sci 2019.

  28. Park F, Soni H, Pressly JD et al (2019) Acute hydroxyurea treatment reduces tubular damage following bilateral ischemia-reperfusion injury in a mouse model of sickle cell disease. Biochem Biophys Res Commun 515:72–76

    Article  CAS  Google Scholar 

  29. Luo QH, Chen ML, Chen ZL et al (2016) Evaluation of KIM-1 and NGAL as early indicators for assessment of gentamycin-induced nephrotoxicity in vivo and in vitro. Kidney Blood Press Res 41:911–918

    Article  CAS  Google Scholar 

  30. Bailly V, Zhang Z, Meier W et al (2002) Shedding of kidney injury molecule-1, a putative adhesion protein involved in renal regeneration. J Biol Chem 277:39739–39748

    Article  CAS  Google Scholar 

  31. Siew ED, Ware LB, Ikizler TA (2011) Biological markers of acute kidney injury. J Am Soc Nephrol 22:810–820

    Article  Google Scholar 

  32. Olvera-Posada D, Dayarathna T, Dion M et al (2017) KIM-1 is a potential urinary biomarker of obstruction: results from a prospective cohort study. J Endourol 31:111–118

    Article  Google Scholar 

  33. Sabbisetti VS, Waikar SS, Antoine DJ et al (2014) Blood kidney injury molecule-1 is a biomarker of acute and chronic kidney injury and predicts progression to ESRD in type I diabetes. J Am Soc Nephrol 25:2177–2186

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors thank the 23 colleagues in our hospital as healthy volunteers. The authors also thank Xinyan Li (School of Pharmacy, Shanghai Jiao Tong University) for her technical/writing assistance.

Author information

Author notes

  1. Subo Qian and Weimin Xia have contributed equally.

Authors and Affiliations

  1. Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Road, Yangpu, Shanghai, 200092, China

    Subo Qian, Weimin Xia, Yu Wu, Qifeng Cao, Yu Ding, Yunteng Huang & Haibo Shen

Authors
  1. Subo Qian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Weimin Xia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yu Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Qifeng Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yu Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yunteng Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Haibo Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: SQ, YH, HS; Methodology: SQ, WX, YH, HS; Formal analysis and investigation: SQ, WX, YW, QC; Writing—original draft preparation: SQ, WX, YW, YD; Writing—review and editing: SQ, WX, YW, HS; Supervision: HS.

Corresponding author

Correspondence to Haibo Shen.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Xinhua Hospital and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Qian, S., Xia, W., Wu, Y. et al. Urinary kidney injury molecule-1: a novel biomarker to monitor renal function in patients with unilateral ureteral obstruction. Int Urol Nephrol 52, 2065–2072 (2020). https://doi.org/10.1007/s11255-020-02528-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-020-02528-5

Keywords

Search

Navigation