Sanaz Keshavarz Shahbaz1,2, Fatemeh Pourrezagholi3, Mohesn Nafar3, Pedram Ahmadpoor3, Mehri Barabadi2, Farshad Foroughi4, Morteza Hosseinzadeh5, Mir Saeed Yekaninejad6, Aliakbar Amirzargar7,8. 1. Department of Immunology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2. Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Building No. 7, Poursina Ave, Tehran, Iran. 3. Department of Nephrology, Chronic Kidney Disease Research Center, Shahid Labbafinejad Medical Center and Shahid Beheshti University of Medical Sciences, Tehran, Iran. 4. Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. 5. Department of Immunology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran. 6. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 7. Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Building No. 7, Poursina Ave, Tehran, Iran. amirzara@sina.tums.ac.ir. 8. Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran. amirzara@sina.tums.ac.ir.
Abstract
BACKGROUND: Acute renal dysfunction still constitutes a highly significant obstacle to renal transplantation outcome. Kidney injury molecule-1 is highly upregulated in proximal tubular cells and shed into the urine and blood circulation following kidney injury. The aim of current cohort study was to evaluate the urine KIM-1 (uKIM-1) mRNA expression level and its protein concentration in blood and urine samples to determine whether sequential monitoring of KIM-1 in renal allograft recipients is a reliable biomarker for predicting the clinical status and outcome. METHODS: Both uKIM-1 mRNA expression level and the level of serum and uKIM-1 protein concentration in the 52 renal transplant recipients were respectively quantified using real-time PCR and ELISA methods at 2, 90 and 180 days after transplantation. RESULT: KIM-1 mRNA and protein expression level in the blood and urine samples of patients with graft dysfunction was significantly higher than patients with well-functioning graft on days 2, 90 and 180 after transplantation. Receiver-operating characteristic curve analysis of mRNA and protein expression levels showed that urinary and blood KIM-1 at months 3 and 6 could predict acute renal dysfunction at 6 months and 1 year after transplantation. CONCLUSION: Sequential monitoring of uKIM-1 mRNA expression level and its protein concentration in the serum and urine samples of renal transplant patients suggests that KIM-1 could be a sensitive and specific biomarker for early diagnosis and prognosis of kidney allograft injury.
BACKGROUND:Acute renal dysfunction still constitutes a highly significant obstacle to renal transplantation outcome. Kidney injury molecule-1 is highly upregulated in proximal tubular cells and shed into the urine and blood circulation following kidney injury. The aim of current cohort study was to evaluate the urine KIM-1 (uKIM-1) mRNA expression level and its protein concentration in blood and urine samples to determine whether sequential monitoring of KIM-1 in renal allograft recipients is a reliable biomarker for predicting the clinical status and outcome. METHODS: Both uKIM-1 mRNA expression level and the level of serum and uKIM-1 protein concentration in the 52 renal transplant recipients were respectively quantified using real-time PCR and ELISA methods at 2, 90 and 180 days after transplantation. RESULT: KIM-1 mRNA and protein expression level in the blood and urine samples of patients with graft dysfunction was significantly higher than patients with well-functioning graft on days 2, 90 and 180 after transplantation. Receiver-operating characteristic curve analysis of mRNA and protein expression levels showed that urinary and blood KIM-1 at months 3 and 6 could predict acute renal dysfunction at 6 months and 1 year after transplantation. CONCLUSION: Sequential monitoring of uKIM-1 mRNA expression level and its protein concentration in the serum and urine samples of renal transplant patients suggests that KIM-1 could be a sensitive and specific biomarker for early diagnosis and prognosis of kidney allograft injury.