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Is Kidney Injury Molecule 1 a Valuable Tool for the Early Diagnosis of Contrast-Induced Nephropathy?
  1. Derya Akdeniz, MD*,
  2. Huseyin Tugrul Celik, MD,
  3. Fatmanur Kazanci, MD,
  4. Hakki Yilmaz, MD,
  5. Serkan Yalcin, MD*,
  6. Mukadder Ayse Bilgic, MD,
  7. Nuket Ruzgaresen, MD,
  8. Ali Akcay, MD,
  9. Beyhan Eryonucu, MD§
  1. From the *Department of Internal Medicine, †Department of Biochemistry, ‡Division of Nephrology, Department of Internal Medicine, and §Department of Cardiology, Turgut Ozal University Faculty of Medicine, Ankara, Turkey
  1. Reprints: Derya Akdeniz, MD, Alparslan Turkes Cad. No:57 06510 Emek/Ankara/Turkey. E-mail: deryaakdeniz1{at}gmail.com, deryaakdeniz84{at}hotmail.com.

Abstract

Aim/Scope Contrast-induced nephropathy (CIN) is a common complication of diagnostic/therapeutic procedures. Serum creatinine levels are sensitive but often lead to diagnostic delays in acute kidney injury and potential misclassification of actual injury status. Kidney injury molecule (KIM-1) is a novel early marker of acute kidney injury. The aim of our study was to evaluate the KIM-1 levels in patients with CIN. We performed a single-center, nested case-control study.

Materials and Methods Three thousand two hundred patients who had undergone coronary angiography were included in the study. Thirty-two patients were diagnosed with CIN. Twenty patients who had undergone coronary angiography but did not have CIN were evaluated as a control group (n = 20). The diagnosis of CIN was performed according to the KDIGO 2012 Acute Kidney Injury Guideline criteria. Urinary KIM-1 levels were measured by enzyme-linked immunosorbent assay before as well as on the 6th and 48th hours of contrast exposure. Serum creatinine levels were measured before as well as on the 24th and 48th hours after angiographic procedure.

Results We demonstrated that KIM-1 levels increased in the patients with CIN significantly on the sixth hour when compared with the baseline (P < 0.01; median levels, 0.27 and 0.70 mg/dL) but not in the controls (P = 0.107). The precontrast and 48th-hour KIM-1 levels were median ones and were also significantly different (P = 0.001, the median levels were 0.27 and 0.60 mg/dL, respectively).

Conclusions Because creatinine is a sensitive but a late marker of CIN, KIM-1 may be used for early diagnosis and early initiation of treatment and may reduce risk for morbidity.

Key Words
  • acute kidney Injury
  • contrast-induced nephropathy
  • kidney injury molecule 1

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