Tubular expression of KIM-1 does not predict delayed function after transplantation.
Injured epithelial cells of the proximal tubule upregulate the glycoprotein kidney injury molecule 1 (KIM-1), suggesting its potential as a biomarker of incipient kidney allograft injury. It is unknown whether KIM-1 expression changes in kidney allografts with delayed graft function (DGF), which often follows ischemia-reperfusion injury. Here, we prospectively measured KIM-1 RNA and protein expression in preperfusion biopsies of 30 living- and 85 deceased-donor kidneys and correlated the results with histologic and clinical outcomes after transplantation. We detected KIM-1 expression in 62% of deceased-donor kidneys and only 13% of living-donor kidneys (P < 0.0001). The level of KIM-1 expression before reperfusion correlated inversely with renal function at the time of procurement and correlated directly with the degree of interstitial fibrosis. Surprising, however, we did not detect a significant correlation between KIM-1 staining intensity and the occurrence of DGF. Our findings are consistent with a role for KIM-1 as an early indicator of tubular injury but do not support tissue KIM-1 measurement before transplantation to identify kidneys at risk for DGF.
Schröppel
Bernd
B
Division of Nephrology, Mount Sinai School of Medicine, New York, NY 10029-6574, USA. bernd.schroppel@mssm.edu
Krüger
Bernd
B
Walsh
Liron
L
Yeung
Melissa
M
Harris
Shay
S
Garrison
Krista
K
Himmelfarb
Jonathan
J
Lerner
Susan M
SM
Bromberg
Jonathan S
JS
Zhang
Ping L
PL
Bonventre
Joseph V
JV
Wang
Zhu
Z
Farris
Alton B
AB
Colvin
Robert B
RB
Murphy
Barbara T
BT
Vella
John P
JP
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000378:metabolism*; D001706:Biopsy; D002102:Cadaver; D051799:Delayed Graft Function / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005355:Fibrosis; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008562:Membrane Glycoproteins / Q000235:genetics* / Q000378:metabolism*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011991:Receptors, Virus / Q000235:genetics* / Q000378:metabolism*; D015427:Reperfusion Injury / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D014184:Transplantation, Homologous; D055815:Young Adult
D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D008562:Membrane Glycoproteins; D011991:Receptors, Virus