KIM-1 expression predicts renal outcomes in IgA nephropathy

Background Kidney injury molecule-1 (KIM-1) is a sensitive biomarker for proximal tubular injury. Recently, a few studies have shown that urinary KIM-1 has clinical implications in IgA nephropathy (IgAN). We performed this study to determine whether tissue KIM-1 has clinical implications for predict...

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Bibliographic Details
Published in:Clinical and experimental nephrology 2013-06, Vol.17 (3), p.359-364
Main Authors: Kwon, Soon Hyo, Park, Moo Yong, Jeon, Jin Seok, Noh, Hyunjin, Choi, Soo Jeong, Kim, Jin Kuk, Hwang, Seung Duk, Jin, So Young, Han, Dong Cheol
Format: Article
Language:English
Subjects:
Adult
Biomarkers - urine
Female
Glomerulonephritis, IGA - complications
Glomerulonephritis, IGA - pathology
Hepatitis A Virus Cellular Receptor 1
Humans
Immunohistochemistry
Kidney - pathology
Male
Medicine
Medicine & Public Health
Membrane Glycoproteins - metabolism
Membrane Glycoproteins - urine
Middle Aged
Nephrology
Original Article
Prognosis
Prospective Studies
Receptors, Virus - metabolism
Retrospective Studies
Urology
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Summary:Background Kidney injury molecule-1 (KIM-1) is a sensitive biomarker for proximal tubular injury. Recently, a few studies have shown that urinary KIM-1 has clinical implications in IgA nephropathy (IgAN). We performed this study to determine whether tissue KIM-1 has clinical implications for predicting long-term outcome and whether urinary KIM-1 is correlated with tissue KIM-1 and kidney injury in IgAN patients. Methods We assessed the prognostic prediction capability of tissue KIM-1 expression in 69 adult patients with IgAN retrospectively. Renal biopsies from all patients were scored by a pathologist who was blinded to the clinical data for the pathologic variables. The primary outcome was the composite of a 50 % reduction in eGFR or end-stage renal disease. Tissue KIM-1 expression was assessed semiquantitatively by counting the stained tubules per 100× power field; 0 tubule indicates grade 0; 1–5 tubules, grade 1; 6–10 tubules, grade 2; and more than 10 tubules, grade 3. Comparing urinary KIM-1 and tissue KIM-1 expression, 50 consecutive IgAN patients were prospectively enrolled to measure urinary KIM-1 levels and examine their biopsy specimens by KIM-1 immunohistochemistry. Results Univariate analysis showed that tissue KIM-1 expression was associated with the renal outcome in IgAN. Multivariate regression analysis, as the relationship of tissue KIM-1 with prognosis, was consistent. Proteinuria at biopsy and tissue KIM-1 grade 3 were shown to have a prognostic value. The concentration of urinary KIM-1/Cr in patients with IgAN was significantly higher than that in the normal controls. Conclusion Tissue KIM-1 expression is an independent predictor of adverse renal outcomes in IgA nephropathy patients.
ISSN:1342-1751
1437-7799
DOI:10.1007/s10157-012-0707-2