Huang Wu, Wang Rong, Zhang Ping
Department of Geriatric Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, People's Republic of China.
Int J Gen Med. 2025 Jan 11;18:145-152. doi: 10.2147/IJGM.S495766. eCollection 2025.
We aimed to address the predictive value of urinary kidney injury molecule-1 (KIM-1), tissue inhibitor of metalloproteinases-2 (TIMP-2) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for contrast-induced acute kidney injury (CI-AKI) in elderly patients after percutaneous coronary intervention (PCI).
One hundred thirty-six patients who underwent PCI were separated into the CI-AKI group (n = 36) and the non-CI-AKI group (n = 100) based on CI-AKI occurrence after operation, and their general data were collected. Blood and urine specimens were collected before operation (at the time of admission) and 6 h, 12 h, 24 h and 48 h after the operation and preserved for future use. Serum creatinine (Scr) levels were tested and an estimated glomerular filtration rate (eGFR) was counted. Urinary KIM-1, TIMP-2 and sTREM-1 levels were assessed and the preoperative and general data as well as postoperative urinary KIM-1, TIMP-2 and sTREM-1 levels were compared. The early diagnostic value of urinary KIM-1, TIMP-2 and sTREM-1 at 6 hours postoperatively for CI-AKI was analyzed by receiver operating characteristic (ROC) curve.
After 48 h of operation, Scr in the CI-AKI group was higher versus the non-CI-AKI group. At 24 h and 48 h postoperatively, eGFR in the CI-AKI group was lower versus the non-CI-AKI group; urinary KIM-1 and sTREM-1 in the CI-AKI group were higher in contrast to the non-CI-AKI group; TIMP-2 in the CI-AKI group was higher versus that in the non-CI-AKI group. ROC curve analysis showed that the areas under the curve (AUCs) for urine KIM-1, TIMP-2, and sTREM-1 in diagnosing CI-AKI at 6 hours postoperatively were 0.852 (95% CI: 0.768-0.936), 0.810 (95% CI: 0.723-0.898), and 0.874 (95% CI: 0.804-0.943), and the cut-off values were 45.93 ng/L, 1.63 ng/mL, and 61.48 ng/L, respectively, with sensitivities of 66.70%, 58.30%, and 72.20%, and specificities of 95.00%, 93.00%, and 91.00%, respectively (all < 0.05).
Urinary KIM-1, TIMP-2 and sTREM-1 can respond to early changes in renal function after PCI and have good application value in the early diagnosis of CI-AKI.
我们旨在探讨尿肾损伤分子-1（KIM-1）、金属蛋白酶组织抑制剂-2（TIMP-2）和髓系细胞表面可溶性触发受体-1（sTREM-1）对老年患者经皮冠状动脉介入治疗（PCI）后对比剂诱导的急性肾损伤（CI-AKI）的预测价值。
136例行PCI的患者根据术后是否发生CI-AKI分为CI-AKI组（n = 36）和非CI-AKI组（n = 100），收集其一般资料。于术前（入院时）及术后6小时、12小时、24小时和48小时采集血、尿标本备用。检测血清肌酐（Scr）水平并计算估算肾小球滤过率（eGFR）。评估尿KIM-1、TIMP-2和sTREM-1水平，并比较术前及一般资料以及术后尿KIM-1、TIMP-2和sTREM-1水平。采用受试者工作特征（ROC）曲线分析术后6小时尿KIM-1、TIMP-2和sTREM-1对CI-AKI的早期诊断价值。
术后48小时，CI-AKI组Scr高于非CI-AKI组。术后24小时和48小时，CI-AKI组eGFR低于非CI-AKI组；CI-AKI组尿KIM-1和sTREM-1高于非CI-AKI组；CI-AKI组TIMP-2高于非CI-AKI组。ROC曲线分析显示，术后6小时尿KIM-1、TIMP-2和sTREM-1诊断CI-AKI的曲线下面积（AUC）分别为0.852（95%CI：(0.768 - 0.936)）、0.810（95%CI：(0.723 - 0.898)）和0.874（95%CI：(0.804 - 0.943)），截断值分别为45.93 ng/L、1.63 ng/mL和61.48 ng/L，灵敏度分别为66.70%、58.30%和72.20%，特异度分别为95.00%、93.00%和91.00%（均(< 0.05)）。
尿KIM-1、TIMP-2和sTREM-1可反映PCI术后肾功能的早期变化，在CI-AKI的早期诊断中具有良好的应用价值。
