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Am J Perinatol 2013; 30(03): 245-252
DOI: 10.1055/s-0032-1323587
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Kidney Injury Molecule-1 as a Promising Biomarker for Acute Kidney Injury in Premature Babies

Gurkan Genc
1   Department of Pediatric Nephrology, Ondokuz Mayis University Faculty of Medicine, Children's Hospital, Samsun, Turkey
,
Ozan Ozkaya
1   Department of Pediatric Nephrology, Ondokuz Mayis University Faculty of Medicine, Children's Hospital, Samsun, Turkey
,
Bahattin Avci
2   Department of Biochemistry, Ondokuz Mayis University Faculty of Medicine, Children's Hospital, Samsun, Turkey
,
Canan Aygun
3   Department of Neonatology, Ondokuz Mayis University Faculty of Medicine, Children's Hospital, Samsun, Turkey
,
Sukru Kucukoduk
3   Department of Neonatology, Ondokuz Mayis University Faculty of Medicine, Children's Hospital, Samsun, Turkey
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Publikationsverlauf

07. März 2012

20. April 2012

Publikationsdatum:
08. August 2012 (online)

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Abstract

Objective To evaluate the role of urinary kidney injury molecule-1 (uKIM-1) in early determination of renal injury in premature infants with respiratory distress syndrome (RDS).

Study Design Forty-eight premature babies hospitalized in the neonatal intensive care unit were included in the study and divided into three groups: group I, healthy premature infants; group II, preterm infants with RDS without acute kidney injury (AKI); group III, preterm infants with RDS and AKI. uKIM-1 and creatinine along with serum creatinine levels were measured with enzyme-linked immunosorbent assay on days 1, 3, and 7 of life.

Results On day 1, uKIM-1 levels in babies with RDS and AKI were higher than the other two groups. In this group, a significant increase in uKIM-1 levels were detected on day 3 (p = 0.015). The sensitivity and specificity of uKIM-1 were calculated as 73.3% and 76.9%, respectively, along with the increase of 0.5 ng per milligram of creatinine of uKIM-1 in day 3, when compared with values on day 1. Elevated uKIM-1 on day 7 was found to increase the risk of death by 7.3 times.

Conclusion Serial uKIM-1 measurements can be used as a noninvasive indicator of kidney injury and uKIM-1 can be an ideal biomarker in premature infants.

Keywords

acute kidney injury - premature - respiratory distress syndrome - KIM-1
 

  • References

  • 1 Tóth-Heyn P, Drukker A, Guignard JP. The stressed neonatal kidney: from pathophysiology to clinical management of neonatal vasomotor nephropathy. Pediatr Nephrol 2000; 14: 227-239
    CrossrefPubMedGoogle Scholar
  • 2 Guignard JP. The adverse renal effects of prostaglandin-synthesis inhibitors in the newborn rabbit. Semin Perinatol 2002; 26: 398-405
    CrossrefPubMedGoogle Scholar
  • 3 Cataldi L, Leone R, Moretti U , et al. Potential risk factors for the development of acute renal failure in preterm newborn infants: a case-control study. Arch Dis Child Fetal Neonatal Ed 2005; 90: F514-F519
    CrossrefPubMedGoogle Scholar
  • 4 Andreoli SP. Acute renal failure in the newborn. Semin Perinatol 2004; 28: 112-123
    CrossrefPubMedGoogle Scholar
  • 5 Askenazi DJ, Feig DI, Graham NM, Hui-Stickle S, Goldstein SL. 3–5 year longitudinal follow-up of pediatric patients after acute renal failure. Kidney Int 2006; 69: 184-189
    CrossrefPubMedGoogle Scholar
  • 6 Karlowicz MG, Adelman RD. Nonoliguric and oliguric acute renal failure in asphyxiated term neonates. Pediatr Nephrol 1995; 9: 718-722
    CrossrefPubMedGoogle Scholar
  • 7 Tanyeri B, Aygun C, Bedir A, Kucukhoduk S, Ozkaya O. Angiotensin converting enzyme gene polymorphisms and acute renal failure in babies with RDS. Early Hum Dev 2008; 84: S99
    PubMedGoogle Scholar
  • 8 Nobilis A, Kocsis I, Tóth-Heyn P , et al. Variance of ACE and AT1 receptor gene does not influence the risk of neonatal acute renal failure. Pediatr Nephrol 2001; 16: 1063-1066
    CrossrefPubMedGoogle Scholar
  • 9 Ichimura T, Hung CC, Yang SA, Stevens JL, Bonventre JV. Kidney injury molecule-1: a tissue and urinary biomarker for nephrotoxicant-induced renal injury. Am J Physiol Renal Physiol 2004; 286: F552-F563
    CrossrefPubMedGoogle Scholar
  • 10 Avery GB, MacDonald MG, Seshia MMK, Mullett MD. Pathophysiology & Management of the Newborn. Avery's Neonatology, 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005
    Google Scholar
  • 11 The International Neonatal Network. The CRIB (clinical risk index for babies) score: a tool for assessing initial neonatal risk and comparing performance of neonatal intensive care units. Lancet 1993; 342: 193-198
    CrossrefPubMedGoogle Scholar
  • 12 Töllner U. Early diagnosis of septicemia in the newborn. Clinical studies and sepsis score. Eur J Pediatr 1982; 138: 331-337
    CrossrefPubMedGoogle Scholar
  • 13 Cataldi L, Leone R, Moretti U , et al. Potential risk factors for the development of acute renal failure in preterm newborn infants: a case-control study. Arch Dis Child Fetal Neonatal Ed 2005; 90: F514-F519
    CrossrefPubMedGoogle Scholar
  • 14 Fanos V, Khoory BJ, Cataldi L. Postischaemic acute renal failure in newborns. Physiopathological aspects and early diagnosis. In: Cataldi L, Fanos V, Simeoni U, , eds. Neonatal Nephrology in Progress. Agorà ed. Lecce; Italy: 1996: 237-249
    Google Scholar
  • 15 Duzova A, Bakkaloglu A, Kalyoncu M , et al; Turkish Society for Pediatric Nephrology Acute Kidney Injury Study Group. Etiology and outcome of acute kidney injury in children. Pediatr Nephrol 2010; 25: 1453-1461
    CrossrefPubMedGoogle Scholar
  • 16 Hentschel R, Lödige B, Bulla M. Renal insufficiency in the neonatal period. Clin Nephrol 1996; 46: 54-58
    PubMedGoogle Scholar
  • 17 Agras PI, Tarcan A, Baskin E, Cengiz N, Gürakan B, Saatci U. Acute renal failure in the neonatal period. Ren Fail 2004; 26: 305-309
    CrossrefPubMedGoogle Scholar
  • 18 Bonventre JV, Yang L. Kidney injury molecule-1. Curr Opin Crit Care 2010; ;Oct 7 [Epub ahead of print]
    PubMedGoogle Scholar
  • 19 Ichimura T, Bonventre JV, Bailly V , et al. 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 1998; 273: 4135-4142
    CrossrefPubMedGoogle Scholar
  • 20 Han WK, Bailly V, Abichandani R, Thadhani R, Bonventre JV. Kidney injury molecule-1 (KIM-1): a novel biomarker for human renal proximal tubule injury. Kidney Int 2002; 62: 237-244
    CrossrefPubMedGoogle Scholar
  • 21 Ichimura T, Hung CC, Yang SA, Stevens JL, Bonventre JV. Kidney injury molecule-1: a tissue and urinary biomarker for nephrotoxicant-induced renal injury. Am J Physiol Renal Physiol 2004; 286: F552-F563
    CrossrefPubMedGoogle Scholar
  • 22 Han WK, Waikar SS, Johnson A , et al. Urinary biomarkers in the early diagnosis of acute kidney injury. Kidney Int 2008; 73: 863-869
    CrossrefPubMedGoogle Scholar
  • 23 Liang XL, Liu SX, Chen YH , et al. Combination of urinary kidney injury molecule-1 and interleukin-18 as early biomarker for the diagnosis and progressive assessment of acute kidney injury following cardiopulmonary bypass surgery: a prospective nested case-control study. Biomarkers 2010; 15: 332-339
    CrossrefPubMedGoogle Scholar
  • 24 Vaidya VS, Waikar SS, Ferguson MA , et al. Urinary biomarkers for sensitive and specific detection of acute kidney injury in humans. Clin Transl Sci 2008; 1: 200-208
    CrossrefPubMedGoogle Scholar
  • 25 Zappitelli M, Washburn KK, Arikan AA , et al. Urine NGAL is an early marker of acute kidney injury in critically ill children: a prospective cohort study. Crit Care 2007; 11: R84
    CrossrefPubMedGoogle Scholar
  • 26 Lavery AP, Meinzen-Derr JK, Anderson E , et al. Urinary NGAL in premature infants. Pediatr Res 2008; 64: 423-428
    CrossrefPubMedGoogle Scholar
  • 27 Parravicini E. The clinical utility of urinary neutrophil gelatinase-associated lipocalin in the neonatal ICU. Curr Opin Pediatr 2010; 22: 146-150
    CrossrefPubMedGoogle Scholar
  • 28 Liangos O, Perianayagam MC, Vaidya VS , et al. Urinary N-acetyl-beta-(D)-glucosaminidase activity and kidney injury molecule-1 level are associated with adverse outcomes in acute renal failure. J Am Soc Nephrol 2007; 18: 904-912
    CrossrefPubMedGoogle Scholar
  • 29 Chiusolo A, Defazio R, Zanetti E , et al. Kidney injury molecule-1 expression in rat proximal tubule after treatment with segment-specific nephrotoxicants: a tool for early screening of potential kidney toxicity. Toxicol Pathol 2010; 38: 338-345
    CrossrefPubMedGoogle Scholar
  • 30 Hoffmann D, Adler M, Vaidya VS , et al. Performance of novel kidney biomarkers in preclinical toxicity studies. Toxicol Sci 2010; 116: 8-22
    CrossrefPubMedGoogle Scholar
  • 31 Chaturvedi S, Farmer T, Kapke GF. Assay validation for KIM-1: human urinary renal dysfunction biomarker. Int J Biol Sci 2009; 5: 128-134
    PubMedGoogle Scholar