The Clinical Utility of Kidney Injury Molecule 1 in the Prediction, Diagnosis and Prognosis of Acute Kidney Injury: A Systematic Review.
Summary of "The Clinical Utility of Kidney Injury Molecule 1 in the Prediction, Diagnosis and Prognosis of Acute Kidney Injury: A Systematic Review."
Objective: This systematic review evaluates the clinical utility of a novel biomarker kidney injury molecule 1 (Kim-1) in the prediction, diagnosis and prognosis of acute kidney injury (AKI). Methods: We searched literature in electronic databases from January 2002 to December 2009 by the key words "kidney injury molecule 1" or "Kim-1" and "acute kidney injury" or "acute renal failure". Studies were eligible for inclusion if they were primary studies published in English, in which Kim-1 was measured for the purpose of prediction, diagnosis or prognosis of AKI in patients. Results: Eight articles met the selection criteria for inclusion in the study. Compared to non AKI patients, Kim-1 increased significantly (at least p<0.05) in AKI patients by 2 hours after cardiac surgery. In the prediction of AKI in patients within 24 hours of cardiac surgery, the sensitivity of Kim-1 ranged from 92% to 100% and AUC between 0.78 and 0.91. Kim-1 increased significantly (at least p<0.05) in AKI established patients, especially in patients with acute tubular necrosis (ATN). The AUC of Kim-1 in the diagnosis of AKI was from 0.9 to 0.95. However, Kim-1 showed weak association with the need of renal replacement therapy and death of AKI patient. Conclusions: Kim-1 is a potential novel urinary biomarker in the early detection of AKI within 24 hours after kidney insult. It might be especially beneficial in the diagnosis of ischemic ATN.
Affiliation
Department of Pathology and Molecular Medicine, McMaster University, 1200 Main Street West, Hamilton, L8S 4J9, Ontario, Canada. yun.huang@medportal.ca.
Journal Details
This article was published in the following journal.
Name: Inflammation & allergy drug targets
ISSN: 1871-5281
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21539514
- DOI: http://dx.doi.org/
Medical and Biotech [MESH] Definitions
Prognosis
A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.
Acute Kidney Injury
Abrupt reduction in kidney function defined as an absolute increase in serum CREATININE of more than or equal to 0.3. mg/dl, a percentage increase in serum creatinine of more than or equal to 50%, or a reduction in urine output. Acute kidney injury encompasses the entire spectrum of the syndrome including acute kidney failure; ACUTE KIDNEY TUBULAR NECROSIS; and other less severe conditions.
Early Diagnosis
Methods to determine in patients the nature of a disease or disorder at its early stage of progression. Generally, early diagnosis improves PROGNOSIS and TREATMENT OUTCOME.
Clinical Enzyme Tests
Analyses for a specific enzyme activity, or of the level of a specific enzyme that is used to assess health and disease risk, for early detection of disease or disease prediction, diagnosis, and change in disease status.
Glomerulosclerosis, Focal Segmental
A clinicopathological syndrome or diagnostic term for a type of glomerular injury that has multiple causes, primary or secondary. Clinical features include PROTEINURIA, reduced GLOMERULAR FILTRATION RATE, and EDEMA. Kidney biopsy initially indicates focal segmental glomerular consolidation (hyalinosis) or scarring which can progress to globally sclerotic glomeruli leading to eventual KIDNEY FAILURE.
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