CLINICAL IMMUNOLOGY
Prognostic value of serum and urine kidney injury molecule-1 in infants with urinary tract infection
1
Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland
2
Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland
Submission date: 2019-05-30
Final revision date: 2019-07-28
Acceptance date: 2019-07-29
Publication date: 2019-09-30
Cent Eur J Immunol 2019;44(3):262-268
KEYWORDS
ABSTRACT
Introduction:
Kidney injury molecule-1 (KIM-1) is an important diagnostic and prognostic marker in acute kidney injury and chronic kidney disease of various aetiologies. The aim of the study was to evaluate the usefulness of serum KIM-1 (sKIM-1) and urine KIM-1 (uKIM-1) for predicting febrile and non-febrile urinary tract infection (UTI) in infants.
Material and methods:
A prospective study included 101 children divided into three groups: febrile UTI 49 children, non-febrile UTI 22 children, and healthy controls 30 children. The following laboratory tests were performed: sKIM-1, uKIM-1, white blood count (WBC), C-reactive protein (CRP), and procalcitonin (PCT).
Results:
Median levels of sKIM-1 were significantly higher in the febrile and non-febrile UTI group compared to the healthy controls (both p < 0.05). Mean levels of uKIM-1 were significantly lower in the febrile UTI group compared to the non-febrile UTI group and healthy controls (p < 0.001 and p < 0.0001, respectively). Univariate logistic regression analysis has demonstrated a positive association of sKIM-1 with febrile and non-febrile UTI (both p < 0.05), and negative association uKIM-1 with febrile UTI (p < 0.0001). Receiver operating curve (ROC) analysis showed good diagnostic profiles of uKIM-1 with a best cut-off value of 2.4 ng/ml and sKIM-1 with a best cut-off value of 3.88 ng/ml for predicting febrile UTI (area under the curve [AUC] 0.82 and 0.67, sensitivity 73% and 63%, specificity 86% and 80%, respectively).
Conclusions:
sKIM-1 can be useful for predicting febrile UTI. We do not recommended use of uKIM-1 as a marker of febrile UTI because of its negative association with febrile UTI. Both markers are not useful for predicting non-febrile UTI.
Kidney injury molecule-1 (KIM-1) is an important diagnostic and prognostic marker in acute kidney injury and chronic kidney disease of various aetiologies. The aim of the study was to evaluate the usefulness of serum KIM-1 (sKIM-1) and urine KIM-1 (uKIM-1) for predicting febrile and non-febrile urinary tract infection (UTI) in infants.
Material and methods:
A prospective study included 101 children divided into three groups: febrile UTI 49 children, non-febrile UTI 22 children, and healthy controls 30 children. The following laboratory tests were performed: sKIM-1, uKIM-1, white blood count (WBC), C-reactive protein (CRP), and procalcitonin (PCT).
Results:
Median levels of sKIM-1 were significantly higher in the febrile and non-febrile UTI group compared to the healthy controls (both p < 0.05). Mean levels of uKIM-1 were significantly lower in the febrile UTI group compared to the non-febrile UTI group and healthy controls (p < 0.001 and p < 0.0001, respectively). Univariate logistic regression analysis has demonstrated a positive association of sKIM-1 with febrile and non-febrile UTI (both p < 0.05), and negative association uKIM-1 with febrile UTI (p < 0.0001). Receiver operating curve (ROC) analysis showed good diagnostic profiles of uKIM-1 with a best cut-off value of 2.4 ng/ml and sKIM-1 with a best cut-off value of 3.88 ng/ml for predicting febrile UTI (area under the curve [AUC] 0.82 and 0.67, sensitivity 73% and 63%, specificity 86% and 80%, respectively).
Conclusions:
sKIM-1 can be useful for predicting febrile UTI. We do not recommended use of uKIM-1 as a marker of febrile UTI because of its negative association with febrile UTI. Both markers are not useful for predicting non-febrile UTI.
REFERENCES (38)
1.
Hansson S, Bollgren I, Esbjörner E, et al. (1999): Urinary tract infection in children below two years of age: a quality assurance oriject in Sweden. Acta Paediatr 88: 270-274.
2.
Shaikh N, Morone NE, Bost JE, et al. (2008): Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J 27: 302-308.
3.
Lee H-E, Kim DK, Kang HK, et al. (2015): The diagnosis of febrile urinary tract infection in children may be facilitated by urinary biomarkers. Pediatr Nephrol 30: 123-130.
4.
Wang P-Y, Chang H-C, Lei R-L, et al. (2016): Personal history and physical examination in judgment of urinary tract infection in children aged 3 months to 2 year. Pediatr Neonatol 57: 274-279.
5.
Kim HH, Chung MH, Bin JH, et al. (2018): Urinary YKL-40 as a candidate biomarker for febrile urinary tract infection in young children. Ann Lab Med 38: 39-45.
6.
Yim HE, Yim H, Bae ES, et al. (2014): Predictive value of urinary and serum biomarkers in young children with febrile urinary tract infections. Pediatr Nephrol 29: 2181-2189.
7.
Valdimarsson S, Jodal U, Barregård L, et al. (2017): Urine neutrophil gelatinase-associated lipocalin and other biomarkers in infants with urinary tract infection and in febrile controls. Pediatr Nephrol 32: 2079-2087.
8.
Petrovic S, Bogavac-Stanojevic N, Peco-Antic A, et al. (2013): Clinical application neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 as indicators of inflammation persistence and acute kidney injury in children with urinary tract infection. Biomed Res Int 2013: 947157.
9.
Krzemień G, Szmigielska A, Turczyn A, et al. (2016): Urine interleukin-6, interleukin-8 and transforming growth factor 1 in infants with urinary tract infection and asymptomatic bacteriuria. Centr Eur J Immunol 41: 260-267.
10.
Krzemień G, Pańczyk-Tomaszewska, Adamczuk D, et al. (2018): Neutrophil gelatinase-associatedl lipocalin: a biomarker for early diagnosis of urinary tract infections in infants. Advs Exp Med Biol 38: 71-80.
11.
Ichimura T, Bonventre JV, Bailly JV, et al. (1998): Kidney injury molecule-1 (KIM-1), a putative epithelial cell adhesion molecule containing a novel immunoglobulin domain, is up-regulated in renal cell after injury. J Biol Chem 273: 4135-4142.
12.
Moresco RN, Bochi GV, Stein CS, et al. (2018): Urinary kidney injury molecule-1 in renal disease. Clin Chim Acta 487: 15-21.
13.
Urbschat A, Obermüller N, Paulus P, et al. (2014): Upper and lower urinary tract infections can be detected early but not be discriminated by urinary NGAL in adults. Int Urol Nephrol 46: 2243-2249.
14.
Han WK, Waikar SS, Johnson A, et al. (2008): Urinary biomarkers in the early diagnosis of acute kidney injury. Kidney Int 73: 863-869.
15.
Waikar SS, Bonventre JV (2008): Biomarkers for the diagnosis of acute kidney injury. Nephron Clin Pract 109: c192-c197.
16.
Wang J-J, Chi N-H, Huang T-M, et al. (2018): Urinary biomarkers predict advanced acute kidney injury after cardiovascular surgery. Crit Care 22: 108: 1-13.
17.
Fan H, Zhao Y, Sun M et al. (2018): Urinary neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, N-acetyl--D-glucosaminidasw levels and mortality risk in septic patients with acute kidney injury. Arch Med Sci 14: 1381-1386.
18.
Westhoff JH, Seibert FS, Waldherr S, et al. (2017): Urinary calprotectin, kidney injury molecule-1, and neutrophil gelatinase-associated lipocalin for the prediction of adverse outcome in pediatric acute kidney injury. Eur J Pediatr 176: 745-755.
19.
Seibert FS, Sitz M, Passfall J, et al. (2018): Prognostic value of urinary calprotectin, NGAL and KIM-1 in chronic kidney disease. Kidney Blood Press Res 43: 1255-1262.
20.
Yin C, Wang N (2016): Kidney injury molecule-1 in kidney disease. Ren Fail 38: 1567-1573.
21.
Li Z, Shen C, Wang Y, et al. (2016): Circulating kidney injury molecule-1 is a novel diagnostic biomarker for renal dysfunction during long-term adefovir therapy in chronic hepatitis B. Medicine (Baltimore) 95: e5264.
22.
Skowron B, Baranowska A, Dobrek L, et al. (2018): Urinary neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, uromodulin, and cystatin C concentrations in an experimental rat model of ascending acute kidney injury induced by pyelonephritis. J Physiol Pharmacol 69: 625-637.
23.
Moledina DG, Hall IE, Thiessen-Philbrook H, et al. (2017): Performance of serum creatinine and kidney injury biomarkers for diagnosing histologic acute tubular injury. Am J Kidney Dis 70: 807-816.
24.
Askenazi DJ, Koralkar R, Levitan EB, et al. (2011): Baseline values of Candidate Urine Acute Kidney Injury (AKI) Biomarkers Vary by Gestational Age in Premature Infants. Pediatr Res 70: 302-306.
25.
Nadkarni GN, Coca SG, Meisner A, et al. (2017): Urinalysis findings and urinary kidney injury biomarker concentrations. BMC Nephrol 18: 218.
26.
Sabbisetti VS, Waikar SS, Antoine DJ, et al. (2014): Blood Kidney Injury Molecule-1 is a biomarker of acute and chronic kidney injury and predicts progression to ESRD in type I diabetes. J Am Soc Nephrol 25: 2177-2186.
27.
Kuwata K, Nakamura I, Ide M, et al. (2015): Comparison of changes in urinary and blood levels of biomarkers associated with proximal tubular injury in rat models. J Toxicol Pathol 28: 151-164.
28.
Ibrahim NE, McCarthy CP, Shrestha S, et al. (2018): Blood kidney injury molecule-1 predicts short and longer term kidney outcomes in patients undergoing diagnostic coronary and/or peripheral angiography-results from the Catheter Sampled Blood Archive in Cardiovascular Diseases (CASABLANCA) study. Am Heart J 209: 36-46.
29.
Nowak N, Skupien J, Niewczas MA, et al. (2016): Increased plasma kidney injury molecule-1 suggests early progressive renal decline in non-proteinuric patients with type 1 diabetes. Kidney Int 89: 459-467.
30.
Colombo M, Looker HC, Farran B, et al. (2019): Serum kidney injury molecule 1 and 2-microglobulin perform as well as larger biomarkers panels for prediction of rapid decline in renal function in type 2 diabetes. Diabetologia 62: 156-168.
31.
Shahbaz SK, Pourrezagholi F, Barabadi M, et al. (2017): High expression of TIM-3 and KIM-1 in blood and urine of renal allograft rejection patients. Transpl Immunol 43-44: 11-20.
32.
Schultz CA, Engström G, Nilsson J, et al. (2019): Plasma kidney injury molecule-1 (KIM-1) levels and deterioration of kidney function over 16 years. Nephrol Dial Transplant; doi: 10.1093/ndt/gfy382 [Epub ahead of print].
33.
Kamianowska M, Szczepański M, Kulikowska EE, et al. (2017): Do serum and urinary concentration of kidney injury molecule-1 in healthy newborns depend on birth weight, gestational age or gender ? J Perinatol 37: 73-76.
34.
Zwiers AJ, deWildt SN, de Rijke YB, et al. (2015): Reference intervals for renal injury biomarkers neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 in young infants. Clin Chem Lab Med 53: 1279-1289.
35.
Bennett MR, Nehus E, Haffner C, et al. (2015): Pediatric reference ranges for acute kidney injury biomarkers. Pediatr Nephrol 30: 677-685.
36.
McWilliam SJ, Antoine DJ, Sabbisetti V, et al. (2014): Reference intervals for urinary renal injury biomarkers KIM-1 and NGAL in healthy children. Biomark Med 8: 1189-1197.
37.
Pennemans V, Rigo JM, Faes C, et al. (2013): Estabilishment of reference values for novel urinary biomarkers for renal damage in the healthy population: are age and gender an issue? Clin Chem Lab Med 51: 1795-1802.
38.
Schley G, Köberle C, Manuilova E, et al. (2015): Comparison of plasma and urine biomarker performance in acute kidney injury. PLoS One 10: e0145042.
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