Detction of urinary kidney injury molecule-1 for diagnosis of early graft function in kidney transplantation / 中国组织工程研究

ABSTRACT

BACKGROUND: Urinary kidney injury molecule-1 (KIM-1) has been proved to be a novel kidney-specific injury molecule as a marker for the diagnosis of acute renal ischemia injury, and KIM-1 participated in the progress of renal injury repair. However, no one reported the significance of its dynamic expression during the functional rehabilitation of renal graft.OBJECTIVE: To investigate the relations between urinary KIM-1 level and the early renal graft function in order to provide rational approaches for evaluating or predicting early renal graft function.METHODS: The 46 patients were divided into 3 groups, including 22 cases of immediate graft function (IGF), 14 cases of slow graft function (SGF) and 10 cases of delayed graft function (DGF). The 24-hour urine specimen was collected every day for 2 weeks since the operation. The urinary KIM-1 content was detected by enzyme linked immunosorbent assay (ELISA), and at the same time the urinary and serum creatinine levels were detected. The diversity of urinary KIM-1 level was observed during the recovery of the graft function, and the clinical significance was evaluated by analyzing the correlation of urinary KIM-1 level and serum creatinine.RESULTS AND CONCLUSION: At the first 2 days after kidney transplantation, the urinary KIM-1 levels were high and no significant difference was observed between the three groups (P < 0.05). Two days later, the urinary KIM-1 level descended quickly along with the descent of the serum creatinine in IGF and SGF groups; the urinary KIM-1 maintained high levels until the serum creatinine reached normally. In DGF group, the urinary KIM-1 decreased quickly to a low level after 2 days from operation, but it increased promptly 1 to 2 days before the recovery of graft function and kept a high level until the serum creatinine reached normally. This suggested that consecutive detection of urinary KIM-1 is useful for monitoring the early graft function after kidney transplantation, and high urinary KIM-1 may suggest the recovery of graft function.