KIM-1 as the biomarker of acute kidney injury in patients with the acute coronary syndrome and oncological diseases
Z.D. Mikhailova, D.V. Pivovarov, S.M. Rumyantseva, A.R. Pivovarova
1) City Clinical Hospital № 38, Nizhny Novgorod, Russia;
2) Nizhny Novgorod Regional Hospital n.a. N.A. Semashko, Nizhny Novgorod, Russia
Background. Patients with acute coronary syndrome (ACS) and oncological diseases (OD) have the increased risk of development of acute kidney injury (AKI) that can worsen the prognosis of a disease. KIM-1 (kidney injury molecule) is a perspective biomarker for early diagnostics of AKI.
Objective. Evaluation of diagnostic and predictive value of urinary KIM-1 levels in patients with ACS and OD.
Material and methods. The study included 87 patients. Patients were divided in two groups: 1) main group: ACS in combination with OD (ACS+OD; n=40); 2) comparison group: ACS without OD (ACS-OD; n=47). On the first day of admission to the hospital, average portion of morning urine was collected in order to determine the KIM-1 level (pg/ml).
Results. The median urinary KIM-1 level in ACS patients (n=87) was 725.6 (420.0-1087.5) pg/ml. Patients in the ACS+OD group had higher KIM-1 levels 921.0 (425.1-1314.8) and 658.0 (345.6-921.4) pg/ml (Р=0.011). In patients with AKI (n=28) compared to the patients without AKI (n=59), urinary KIM-1 level was higher: 999.3 (478.7-1303.3) and 668.2 (365.5-955.6) pg/ml
(Р =0.023). ROC analysis revealed that urinary KIM-1 level > 1047.23 pg/ml allowed to predict the development of contrast-induced AKI (CI-AKI) in ACS patients after selective coronary angiography (n=79) (AUC – 0.774; 95% CI, 0.666-0.860; Р <0.001); and also in patients with ACS and OD (n=35) (AUC – 0.728; 95% CI, 0.552-0.864; Р=0.010) with a cut-off point > 1221.49 pg/ml.
Conclusion. The increased urinary KIM-1 level was observed in development of AKI; however, KIM-1 showed the greatest importance as an early biomarker of CI-AKI.
Keywords: acute kidney injury, contrast-induced acute kidney injury, KIM-1, acute coronary syndrome, oncological diseases
About the Autors
Zinaida D. Mikhailova – Dr.Sci. (Med.), Associate Professor; Consultant at the City Clinical Hospital № 38, Nizhny Novgorod, Russia; e-mail: firstname.lastname@example.org. https://orcid.org/0000-0002-0926-6038
Dmitry V. Pivovarov – Therapist at the City Clinical Hospital № 38, Nizhny Novgorod, Russia; e-mail: email@example.com. https://orcid.org/0000-0002-6642-1364
Svetlana M. Rumyantseva – Head of the Urgent Cardiology Intensive Care Unit, Nizhny Novgorod Regional Hospital n.a. N.A. Semashko, Nizhny Novgorod, Russia; e-mail: SMRumyantseva@yandex.ru. https://orcid.org/0000-0002-1317-6086
Almira R. Pivovarova – Therapist at the City Clinical Hospital № 38, Nizhny Novgorod, Russia; e-mail: firstname.lastname@example.org. https://orcid.org/0000-0002-1997-9621