Urinary kidney injury molecule‑1 as an early indicator to predict contrast‑induced acute kidney injury in patients with diabetes mellitus undergoing percutaneous coronary intervention

Li,Wenhua; Yu,Yaren; He,Haiyan; Chen,Jing; Zhang,Debin

doi:10.3892/br.2015.449

July-2015 Volume 3 Issue 4

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July-2015 Volume 3 Issue 4

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Article

Urinary kidney injury molecule‑1 as an early indicator to predict contrast‑induced acute kidney injury in patients with diabetes mellitus undergoing percutaneous coronary intervention

Authors:
- Wenhua Li
- Yaren Yu
- Haiyan He
- Jing Chen
- Debin Zhang
View Affiliations / Copyright

Affiliations: Department of Cardiology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu 221002, P.R. China
Pages: 509-512
|
Published online on: April 16, 2015

https://doi.org/10.3892/br.2015.449
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Abstract

With the improvement of the skill level of coronary intervention, contrast agents are used more widely. As a result, contrast‑induced acute kidney injury (CI‑AKI) is currently the third leading cause of hospital‑acquired AKI. Traditionally, AKI is defined by measuring an increase of the serum creatinine concentration (Scr). CI‑AKI indicates impairment in renal function, which is diagnosed as an elevation in the SCr levels following intravascular injection of the contrast media. However, Scr is an insensitive indicator for detecting CI‑AKI. The present study was designed to investigate whether human urinary kidney injury molecule‑1 (KIM‑1) is an early marker to predict CI‑AKI in patients with diabetes mellitus undergoing percutaneous coronary intervention (PCI). The present study includes the general clinical data of 145 patients with diabetes mellitus who underwent PCI between March 1, 2013 and December 31, 2013. A non‑ionic, low osmolarity contrast agent was used during the present study. The Scr levels and estimated glomerular filtration rate were measured prior to and within 24 and 48 h after the injection of contrast agents. Urinary samples were collected prior to and within 2, 6, 12, 24 and 48 h after the coronary interventional procedure. Simultaneously, the urinary KIM‑1 values were measured using an ELISA kit. CI‑AKI was diagnosed as an increase of ≥0.5 mg/dl or ≥25% in Scr concentration over baseline, 24‑48 h after the procedure. In total, 19 of 145 (13.1%) patients exhibited CI‑AKI. There was a significant difference (P<0.05) between the urinary KIM‑1 levels measured 2, 6, 12, 24 and 48 h after the procedure and those prior to the procedure in the CI‑AKI group. There was no significant difference between the Scr values measured 24 h after the procedure and those prior to the procedure. Evidently, using KIM‑1 values to predict CI‑AKI was <24 h earlier compared to using Scr values. The area under the receiver operating characteristic curve of KIM‑1 24 h after the procedure was 0.856 and the 95% confidence interval of the corresponding area was 0.782‑0.929. When the pivotal point of CI‑AKI diagnosis was 6,327.755 pg/ml, the specificity was 85.7% and the sensitivity was 73.7%. Univariate analysis showed that the Scr concentration was positively correlated with the urinary KIM‑1 level during the time prior to the procedure and 24 and 48 h after the procedure. In conclusion, the urinary KIM‑1 may be a potential indicator for the early diagnosis of CI‑AKI.

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1	Caixeta A and Mehran R.: Evidence-based management of patients undergoing PCI: contrast-induced acute kidney injury. Catheter Cardiovasc Interv. 75 (Suppl 1):S15–S20. 2010. View Article : Google Scholar : PubMed/NCBI
2	Parfrey P: The clinical epidemiology of contrast-induced nephropathy. Cardiovasc Intervent Radiol. 28 (Suppl 2):S3–S11. 2005. View Article : Google Scholar : PubMed/NCBI
3	Mehran R and Nikolsky E: Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney Int. Suppl (100):S11–S15. 2006. View Article : Google Scholar
4	Odutayo A and Cherney D: Cystatin C and acute changes in glomerular filtration rate. Clin Nephrol. 78:64–75. 2012. View Article : Google Scholar : PubMed/NCBI
5	Mehran R: Contrast-induced nephropathy remains a serious complication of PCI. J Interv Cardiol. 20:236–240. 2007. View Article : Google Scholar : PubMed/NCBI
6	Tonomura Y, Tsuchiya N, Torii M and Uehara T: Evaluation of the usefulness of urinary biomarkers for nephrotoxicity in rats. Toxicology. 273:53–59. 2010. View Article : Google Scholar : PubMed/NCBI
7	Huo W, Zhang K, Nie Z, Li Q and Jin F: Kidney injury molecule-1 (KIM-1): A novel kidney-specific injury molecule playing potential double-edged functions in kidney injury. Transplant Rev (Orlando). 24:143–146. 2010. View Article : Google Scholar : PubMed/NCBI
8	Malhis M, Al-Bitar S and Al-Deen Zaiat K: The role of theophylline in prevention of radiocontrast media-induced nephropathy. Saudi J Kidney Dis Transpl. 21:276–283. 2010.PubMed/NCBI
9	McCullough PA and Soman SS: Contrast-induced nephropathy. Crit Care Clin. 21:261–280. 2005. View Article : Google Scholar : PubMed/NCBI
10	Shaw JE, Sicree RA and Zimmet PZ: Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 87:4–14. 2010. View Article : Google Scholar : PubMed/NCBI
11	Han W K, Bailly V, Abichandani R, Thadhani R and Bonventre JV: Kidney Injury Molecule-1 (KIM-1): A novel biomarker for human renal proximal tubule injury. Kidney Int. 62:237–244. 2002. View Article : Google Scholar : PubMed/NCBI
12	Parikh CR, Abraham E, Ancukiewicz M and Edelstein CL: Urine IL-18 is an early diagnostic marker for acute kidney injury and predicts mortality in the intensive care unit. J Am Soc Nephrol. 16:3046–3052. 2005. View Article : Google Scholar : PubMed/NCBI
13	Melnikov VY, Ecder T, Fantuzzi G, et al: Impaired IL-18 processing protects caspase-1-deficient mice from ischemic acute renal failure. J Clin Invest. 107:1145–1152. 2001. View Article : Google Scholar : PubMed/NCBI
14	Heyman S N, Rosen S and Rosenberger C: Renal parenchymal hypoxia, hypoxia adaptation, and the pathogenesis of radiocontrast nephropathy. Clin J Am Soc Nephrol. 3:288–296. 2008. View Article : Google Scholar : PubMed/NCBI
15	Katzberg RW: Contrast medium-induced nephrotoxicity: Which pathway? Radiology. 235:752–755. 2005. View Article : Google Scholar : PubMed/NCBI
16	Bailly V, Zhang Z, Meier W, et al: Shedding of kidney injury molecule-1, a putative adhesion protein involved in renal regeneration. J Biol Chem. 277:39739–39748. 2002. View Article : Google Scholar : PubMed/NCBI
17	Vaidya VS, Ramirez V, Ichimura T, et al: Urinary kidney injury molecule-1: A sensitive quantitative biomarker for early detection of kidney tubular injury. Am J Physiol Renal Physiol. 290:F517–F529. 2006. View Article : Google Scholar : PubMed/NCBI
18	Ichimura T, Bonventre J V, 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. 273:4135–4142. 1998. View Article : Google Scholar : PubMed/NCBI
19	Thomsen HS: How to avoid CIN: guidelines from the European Society of Urogenital Radiology. Nephrol Dial Transplant. 20 (Suppl 1):i18–i22. 2005. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Urinary kidney injury molecule‑1 as an early indicator to predict contrast‑induced acute kidney injury in patients with diabetes mellitus undergoing percutaneous coronary intervention

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Abstract

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