Urine kidney injury molecule-1 in the early diagnosis of early-stage acute kidney injury after lung transplantation

Objectives To investigate the value of kidney injury molecule-1 (KIM-1) in the early diagnosis of early-stage acute kidney injury (AKI) in patients after lung transplantation.Methods 52 lung transplantation patients hospitalized were enrolled in this prospective study.Blood and urine samples were collected before and at different time points after surgery.The concentrations of serum creatinine (Scr) and urine KIM-1 were measured.According to AKI criteria,patients were divided into the AKI group and non-AKI group.Dynamic changes of levels of Scr and urine KIM-1 were observed in two groups.The receiver operating characteristic curve was used to evaluate the early diagnostic value of urine KIM-1.Results 19 (36.5％) patients developed AKI after lung transplantation.24h after surgery,the level of Scr rose to 1.80 times of the baseline,which met the diagnostic criteria of AKI.In the AKI group,concentrations of urine KIM-1 at 4h time point began to rise significantly from baseline[(1.7 ±0.6) ng/mL versus (0.5 ±0.3) ng/mL,P ＜0.05].At 4h time point after lung transplantation,the area under the curve of urine KIM-1 was 0.837 (95 ％ CI 0.729 ～ 0.946),the sensitivity was 73.7 ％ and specificity was 75.8％ with a cutoff value of 1.6ng/mL.Conclusions Urine KIM-1 can diagnose AKI after lung transplantation earlier than Scr,which may be a good biomarker for early diagnosis of AKI after lung transplantation. Key words: Kidney Diseases;  Lung Transplantation