Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.
Nephrol Dial Transplant. 2011 Oct;26(10):3229-36. doi: 10.1093/ndt/gfr023. Epub 2011 Mar 14.
The pathological characteristics of IgA nephropathy (IgAN) are highly variable. Urinary kidney injury molecule-1 (KIM-1) is a sensitive biomarker for proximal tubule injury. The aim of the study is to investigate the value of KIM-1 as a biomarker for assessing the renal injury in IgAN.
The levels of urinary KIM-1 in 202 patients with IgAN, 46 patients with other renal diseases as disease controls and 60 healthy blood donors as normal controls were measured. Correlations with clinical and histopathological features of patients with IgAN were evaluated.
The levels of urinary KIM-1 were significantly higher in patients with IgAN than in normal controls (P < 0.001) and in patients with non-IgAN (P = 0.011). Urinary levels of KIM-1 in IgAN positively correlated with levels of serum creatinine and proteinuria and negatively with creatinine clearance. The more severe the tubulointerstitial injury was, the higher the levels of urinary KIM-1. Patients with severe mesangial proliferation, crescents formation or endocapillary proliferation had higher levels of urinary KIM-1 than those without. The levels of tubular KIM-1 expression in immunohistochemistry closely correlated with the levels of urinary KIM-1 (r = 0.553, P = 0.032). Renal survival was significantly worse in patients with elevated urinary KIM-1 (P = 0.020).
Urinary KIM-1 may be a useful biomarker to evaluate kidney injury in IgAN.
IgA 肾病（IgAN）的病理特征具有高度变异性。尿肾损伤分子-1（KIM-1）是近端肾小管损伤的敏感生物标志物。本研究旨在探讨 KIM-1 作为评估 IgAN 肾损伤的生物标志物的价值。
检测 202 例 IgAN 患者、46 例其他肾脏疾病患者（疾病对照组）和 60 例健康献血者（正常对照组）的尿 KIM-1 水平，评估其与 IgAN 患者临床和组织病理学特征的相关性。
IgAN 患者尿 KIM-1 水平明显高于正常对照组（P < 0.001）和非 IgAN 患者（P = 0.011）。IgAN 患者尿 KIM-1 水平与血清肌酐和蛋白尿水平呈正相关，与肌酐清除率呈负相关。肾小管间质损伤越严重，尿 KIM-1 水平越高。严重系膜增生、新月体形成或毛细血管内增生的患者尿 KIM-1 水平高于无此病变的患者。免疫组化肾小管 KIM-1 表达水平与尿 KIM-1 水平密切相关（r = 0.553，P = 0.032）。尿 KIM-1 升高的患者肾脏存活率明显较差（P = 0.020）。
尿 KIM-1 可能是评估 IgAN 肾损伤的有用生物标志物。
