title: Kidney injury molecule-1 and osteopontin: new markers for prediction of early kidney transplant rejection.
abstract: BACKGROUND
  Kidney injury molecule-1 (KIM-1) and osteopontin (OPN) play important roles in immune regulation. We hypothesized that serum KIM-1 and OPN might serve as biomarkers for predicting early acute rejection after kidney transplantation (KTx).
  
  
  METHODS
  We conducted a single-center study of 155 subjects, who were classified into acute rejection group (ARG, n=32), non-rejection group (NRG, n=45) and healthy controls (HC, n=78). Serum KIM-1 and OPN levels were measured by Luminex.
  
  
  RESULTS
  The pre-transplant levels of serum KIM-1 and OPN in all KTx recipients were higher than those of HC (P<0.01). Compared with NRG, ARG showed significantly high serum levels of KIM-1 on day 0 (pre-KTx) and on the 1st, 4th, and 7th post-KTx days, and significantly high OPN levels on day 0 and the 7th day. Kaplan-Meier survival analysis showed that the higher levels of KIM-1 on day 0, the 1st and 4th days and OPN on day 0 and the 7th day were significantly associated with the lower probabilities of rejection-free survival. ROC analyses highlight the superiority of KIM-1 on the 1st day and OPN on the 7th day over those on other post-KTx days in prediction of acute rejection episodes. Multivariate logistic analysis revealed that the serum KIM-1 levels on the 1st post-KTx day and the OPN level on the 7th day were independent and powerful predictors of acute rejection episodes. An optimal predictive model was built by combining KIM-1 on the 1st day and OPN on the 7th day, and this model had the highest AUC (0.922).
  
  
  CONCLUSIONS
  This study was the first to demonstrate that serum KIM-1 and OPN may be the promising and elegant markers for prediction of early acute kidney allograft rejection.
authors: Department of Kidney Transplantation, Hospital of Nephropathy, First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
authors: Zhan-Kui
authors: ZK
authors: Jin
authors: Pu-Xun
authors: PX
authors: Tian
authors: Xu-Zhen
authors: XZ
authors: Wang
authors: Wu-Jun
authors: WJ
authors: Xue
authors: Xiao-Ming
authors: XM
authors: Ding
authors: Jin
authors: J
authors: Zheng
authors: Cheng-Guang
authors: CG
authors: Ding
authors: Tian-Ci
authors: TC
authors: Mao
authors: Wan-Li
authors: WL
authors: Duan
authors: Min
authors: M
authors: Xi
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006084:Graft Rejection / Q000097:blood*; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D053495:Osteopontin / Q000097:blood* / Q000276:immunology; D011237:Predictive Value of Tests; D011991:Receptors, Virus / Q000097:blood*
chemical_list: D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D008562:Membrane Glycoproteins; D011991:Receptors, Virus; D053495:Osteopontin