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

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.

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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.

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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.

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The authors declare that they have no conflict of interest.

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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.

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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 (2020). https://doi.org/10.1007/s11255-020-02528-5

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Keywords

  • Acute kidney injury (AKI)
  • Kidney injury molecule-1 (KIM-1)
  • Ureteral calculi
  • Unilateral ureteral obstruction (UUO)