The Marker of Tubular Injury, Kidney Injury Molecule-1 (KIM-1), in Acute Kidney Injury Complicating Acute Pancreatitis: A Preliminary Study
Acute pancreatitis (AP) may be associated with severe inflammation and hypovolemia leading to organ complications including acute kidney injury (AKI). According to current guidelines, AKI diagnosis is based on dynamic increase in serum creatinine, however, creatinine increase may be influenced by no...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-05-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/9/5/1463 |
| _version_ | 1797568135701725184 |
|---|---|
| author | Justyna Wajda Paulina Dumnicka Witold Kolber Mateusz Sporek Barbara Maziarz Piotr Ceranowicz Marek Kuźniewski Beata Kuśnierz-Cabala |
| author_facet | Justyna Wajda Paulina Dumnicka Witold Kolber Mateusz Sporek Barbara Maziarz Piotr Ceranowicz Marek Kuźniewski Beata Kuśnierz-Cabala |
| author_sort | Justyna Wajda |
| collection | DOAJ |
| description | Acute pancreatitis (AP) may be associated with severe inflammation and hypovolemia leading to organ complications including acute kidney injury (AKI). According to current guidelines, AKI diagnosis is based on dynamic increase in serum creatinine, however, creatinine increase may be influenced by nonrenal factor and appears late following kidney injury. Kidney injury molecule-1 (KIM-1) is a promising marker of renal tubular injury and it has not been studied in AP. Our aim was to assess if urinary KIM-1 may be used to diagnose AKI complicating the early stage of AP. We recruited 69 patients with mild to severe AP admitted to a secondary care hospital during the first 24 h from initial symptoms of AP. KIM-1 was measured in urine samples collected on the day of admission and two subsequent days of hospital stay. AKI was diagnosed based on creatinine increase according to Kidney Disease: Improving Global Outcomes 2012 guidelines. Urinary KIM-1 on study days 1 to 3 was not significantly higher in 10 patients who developed AKI as compared to those without AKI and did not correlate with serum creatinine or urea. On days 2 and 3, urinary KIM-1 correlated positively with urinary liver-type fatty acid-binding protein, another marker of tubular injury. On days 2 and 3, urinary KIM-1 was higher among patients with systemic inflammatory response syndrome, and several correlations between KIM-1 and inflammatory markers (procalcitonin, urokinase-type plasminogen activator receptor, C-reactive protein) were observed on days 1 to 3. With a limited number of patients, our study cannot exclude the diagnostic utility of KIM-1 in AP, however, our results do not support it. We hypothesize that the increase of KIM-1 in AKI complicating AP lasts a short time, and it may only be observed with more frequent monitoring of the marker. Moreover, urinary KIM-1 concentrations in AP are associated with inflammation severity. |
| first_indexed | 2024-03-10T19:52:04Z |
| format | Article |
| id | doaj.art-f5e1b54eaf7846529f88b0dbc0b19655 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T19:52:04Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-f5e1b54eaf7846529f88b0dbc0b196552023-11-20T00:21:17ZengMDPI AGJournal of Clinical Medicine2077-03832020-05-0195146310.3390/jcm9051463The Marker of Tubular Injury, Kidney Injury Molecule-1 (KIM-1), in Acute Kidney Injury Complicating Acute Pancreatitis: A Preliminary StudyJustyna Wajda0Paulina Dumnicka1Witold Kolber2Mateusz Sporek3Barbara Maziarz4Piotr Ceranowicz5Marek Kuźniewski6Beata Kuśnierz-Cabala7Jagiellonian University Medical College, Faculty of Medicine, Department of Anatomy, 31-034 Kraków, PolandJagiellonian University Medical College, Faculty of Pharmacy, Department of Medical Diagnostics, 30-688 Kraków, PolandDepartment of Surgery, Complex of Health Care Centers in Wadowice, 34-100 Wadowice, PolandJagiellonian University Medical College, Faculty of Medicine, Department of Anatomy, 31-034 Kraków, PolandJagiellonian University Medical College, Faculty of Medicine, Chair of Clinical Biochemistry, Department of Diagnostics, 31-501 Kraków, PolandJagiellonian University Medical College, Faculty of Medicine, Department of Physiology, 31-531 Kraków, PolandJagiellonian University Medical College, Faculty of Medicine, Department of Nephrology, 30-688 Kraków, PolandJagiellonian University Medical College, Faculty of Medicine, Chair of Clinical Biochemistry, Department of Diagnostics, 31-501 Kraków, PolandAcute pancreatitis (AP) may be associated with severe inflammation and hypovolemia leading to organ complications including acute kidney injury (AKI). According to current guidelines, AKI diagnosis is based on dynamic increase in serum creatinine, however, creatinine increase may be influenced by nonrenal factor and appears late following kidney injury. Kidney injury molecule-1 (KIM-1) is a promising marker of renal tubular injury and it has not been studied in AP. Our aim was to assess if urinary KIM-1 may be used to diagnose AKI complicating the early stage of AP. We recruited 69 patients with mild to severe AP admitted to a secondary care hospital during the first 24 h from initial symptoms of AP. KIM-1 was measured in urine samples collected on the day of admission and two subsequent days of hospital stay. AKI was diagnosed based on creatinine increase according to Kidney Disease: Improving Global Outcomes 2012 guidelines. Urinary KIM-1 on study days 1 to 3 was not significantly higher in 10 patients who developed AKI as compared to those without AKI and did not correlate with serum creatinine or urea. On days 2 and 3, urinary KIM-1 correlated positively with urinary liver-type fatty acid-binding protein, another marker of tubular injury. On days 2 and 3, urinary KIM-1 was higher among patients with systemic inflammatory response syndrome, and several correlations between KIM-1 and inflammatory markers (procalcitonin, urokinase-type plasminogen activator receptor, C-reactive protein) were observed on days 1 to 3. With a limited number of patients, our study cannot exclude the diagnostic utility of KIM-1 in AP, however, our results do not support it. We hypothesize that the increase of KIM-1 in AKI complicating AP lasts a short time, and it may only be observed with more frequent monitoring of the marker. Moreover, urinary KIM-1 concentrations in AP are associated with inflammation severity.https://www.mdpi.com/2077-0383/9/5/1463kidney injury molecule-1acute pancreatitisacute kidney injurybiomarkers of acute kidney injury |
| spellingShingle | Justyna Wajda Paulina Dumnicka Witold Kolber Mateusz Sporek Barbara Maziarz Piotr Ceranowicz Marek Kuźniewski Beata Kuśnierz-Cabala The Marker of Tubular Injury, Kidney Injury Molecule-1 (KIM-1), in Acute Kidney Injury Complicating Acute Pancreatitis: A Preliminary Study Journal of Clinical Medicine kidney injury molecule-1 acute pancreatitis acute kidney injury biomarkers of acute kidney injury |
| title | The Marker of Tubular Injury, Kidney Injury Molecule-1 (KIM-1), in Acute Kidney Injury Complicating Acute Pancreatitis: A Preliminary Study |
| title_full | The Marker of Tubular Injury, Kidney Injury Molecule-1 (KIM-1), in Acute Kidney Injury Complicating Acute Pancreatitis: A Preliminary Study |
| title_fullStr | The Marker of Tubular Injury, Kidney Injury Molecule-1 (KIM-1), in Acute Kidney Injury Complicating Acute Pancreatitis: A Preliminary Study |
| title_full_unstemmed | The Marker of Tubular Injury, Kidney Injury Molecule-1 (KIM-1), in Acute Kidney Injury Complicating Acute Pancreatitis: A Preliminary Study |
| title_short | The Marker of Tubular Injury, Kidney Injury Molecule-1 (KIM-1), in Acute Kidney Injury Complicating Acute Pancreatitis: A Preliminary Study |
| title_sort | marker of tubular injury kidney injury molecule 1 kim 1 in acute kidney injury complicating acute pancreatitis a preliminary study |
| topic | kidney injury molecule-1 acute pancreatitis acute kidney injury biomarkers of acute kidney injury |
| url | https://www.mdpi.com/2077-0383/9/5/1463 |
| work_keys_str_mv | AT justynawajda themarkeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT paulinadumnicka themarkeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT witoldkolber themarkeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT mateuszsporek themarkeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT barbaramaziarz themarkeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT piotrceranowicz themarkeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT marekkuzniewski themarkeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT beatakusnierzcabala themarkeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT justynawajda markeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT paulinadumnicka markeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT witoldkolber markeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT mateuszsporek markeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT barbaramaziarz markeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT piotrceranowicz markeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT marekkuzniewski markeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy AT beatakusnierzcabala markeroftubularinjurykidneyinjurymolecule1kim1inacutekidneyinjurycomplicatingacutepancreatitisapreliminarystudy |