Diagnostic Value of Urinary Kidney Injury Molecule-1 in Diagnosis of Sepsis Associated Acute Kidney Injury
Abstract
Abstract
Background: Sepsis asscociated acute kidney injury (SA-AKI) is common condition that found in sepsis. Due to the lack of creatinine serum, this condition possibly makes therapy delayed. Kidney Injury Molecule-1 (KIM-1) is a a type 1 transmembrane protein with immunoglobulin and mucin domains, which is expressed increased in the proximal tubules of the kidney. Elevated urinary KIM-1 levels are an indicator of AKI. However, previous studies have shown varies results.
Objectives: This study aims to determine early diagnosis biomarkers for the presence of AKI in sepsis.
Methods: This diagnostic test was conducted at Dr. M. Djamil General Hospital Padang in sepsis patients. The diagnosis of AKI was established based on the 2012 KDIGO criteria.
Results: The study involved 94 sepsis patients, only 22,34% (n=21) of them experienced AKI. Serum creatinine levels at admission and within 48 hours of hospitalization were 0,7 (IQR 0,2-1,6) mg/dl and 0,8 (IQR 0,3-2,2m) mg/dl. An urinary KIM-1 level at admission ≥11,74 ng/mL had sensitivity of 44,68%, specificity of 59,57%, positive predictive value of 52,5%, negative predictive value of 51,85%, and accuracy of 52,12% in early diagnosis of AKI in sepsis.
Conclusion: Urinary Kidney injury molecule-1 level has poor diagnostic value in diagnosis of AKI in sepsis.
Keywords: Sepsis, Kidney injury molecule-1, AKI.
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References
2. Kellum J, Romagni P, Ashuntang G, Ronco C, Zarbock A, Anders H. Acute kidney injury. Nat Rev Dis Prim. 2021;7(1):52. doi:10.1038/s41572-021-00284-z
3. Srisawat N, Kulvichit W, Mahamitra N, Hurst C, Praditpornsilpa K, N L. The epidemiology and characteristics of acute kidney injury in the southeast asia intensive care unit : a perspective multicentre study. Nephrol Dial Transpl. 2020;35(10):1729–38. doi:10.1093/ndt/gfz087
4. Mahadevappa R, Nielsen R, I CE, Birn H. Review : megalin in acute kidney injury-foe and friend. Am J Physiol Ren Physiol. 2014;306(2):F147-54. doi:10.1152/ajprenal.00378.2013
5. Moledina DG, Parikh CR. Phenotyping of acute kidney injury : beyond serum creatinine. Semin Nephrol. 2018;38(1):3–11. doi:10.1016/j.semnephrol.2017.09.002
6. Anandkumar DG, Sheerendra PS, Vellakampadi D, Ramanathan G. Kidney injury molecule-1 : is it predictive marker for renal disease? J Nephropharmacol. 2023;12(2):e10572. doi:10.34172/npj.2023.10572
7. Xie Y, Huang P, Zhang J, Tian R, Jin W, H X. Biomarkers for the diagnosis of sepsis-associated acute kidney injury: systematic review and meta-analysis. Ann Palliat Med. 2021;10(4):4159–73. doi:10.21037/apm-20-1855
8. Juwono KAR, Airlangga PS, Semedi BP, Kriswidyatomo P, Waloeo CS, KH S. Urine kidney injury molecule-1 and lactic acid as early predictor of acute kidney inury : a literature review. Bali Med J. 2024;12(3):1303–06. doi:10.15552/bmj.v13i3.5260
9. Mohamed MS, Mahmoud OM, Al-Maraghi SK, Abogabal KM, El-Kholy MB. Kidney injury molecule-1 as a diagnostic and prognostic biomarker for acute kidney injury in septic patients. EJMR. 2024;5(4):236–49. doi:10.21608/ejmr.2024.283655.1606
10. Shaker MA, Mohamed MF, Thabet KK, Ramzy T, Serum AMY, I.L.-. Serum interleukin-18, kidney injury molecule-1, and the renal resistive ndex for predicating acute kidney injury in critically ill patients with sepsis. Saudi J Kidney Dis Transpl. 2023;34(Suppl 1):S153–S160. doi:10.4103/sjkdt.sjkdt_56_22
11. Tejera D, Varela F, Acosta D, Figueroa S, Benencio S, C V. Epidemiology of acute kidney injury and chronic kidney disease in the internsive care unit. Rev Bras Ter Intensiva. 2017;29(4):444–52. doi:10.5935/0103-507x.20170061
12. Matarneh A, Akkari A, Sardar A, Salameh O, Dauleh M, B M. Beyond creatinine : diagnostic accuracy of emergeing biomarkers for AKI in the ICU – a systematic review. Ren Fail Fail. 2025;47(1):2556295. doi:10.1080/0886022x.2025.2556295
13. Puspitasari S, Semedi BP, Rehatta NM, Purnomo W. Comparison of kidney injury molecule-1, proenkephalin, and presepsin as predictorsof diagnostics and severity of sepsis associated acute kidney injury. Edelweiss Appl Sci Technol. 2025;9(2):331–42. doi:10.55214/25768484.v9i2.4481
14. Zhang PL, Liu ML. From acute tubular injury to tubular repair and chronic kidney diseases – KIM-1 as a promising biomarker for predicting renal tubular pathology. Curr Res Physiol. 2025;8:100152. doi:10.1016/j.crphys.2025.100152
15. Yang H, Chen Y, He J, Li Y, Feng Y. Advances in the diagnosis of early biomarkers for acute kidney injury : a literature review. BMC Nephrol. 2025;26(1):115. doi:10.1186/s12882-025-04040-3
16. Ostermann M, Basu RK, Mehta RL. Acute kidney injury. Intensive Care Med. 2023;49(2):219–22. doi:10.1007/s00134-022-06946-0
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