Kidney Injury Molecule-1 (KIM-1) as Biomarker for the Early Identification of Acute Tubular Necrosis

Acute tubular necrosis (ATN) is characterized by tubule cell damage and by cell death that usually results from prolonged renal ischemia and nephrotoxins. For patients with community-acquired ATN without other serious comorbid conditions, the mortality rate is approximately 5% and increase to 80% among patients in the ICU with multiorgan failure. However, no uniform diagnostic criteria for ATN exist. Commonly used criteria include a 50% decline in calculated glomerular filtration rate (GFR) or a 0.5 mg/dL (40 imol/L) increase in serum creatinine level. Recognition of ATN and evaluation of its severity may be delayed by overreliance on surrogate markers of GFR, serum ureum level, and serum creatinine level. Use of current biomarkers is limited by several patient factors. Kidney Injury Molecule-1 (KIM-1) is recognizedas the most promising potential biomarker for the early identification of NTA. An advantage of KIM-1 is that it appears to be more specific, accurate and easier to use. Keyword: acute tubular necrosis, acute kidney injury, biomarker, early detection, KIM-1