title: Urinary Kidney injury molecule-1 can predict delayed graft function in living donor renal allograft recipients.
abstract: OBJECTIVE
  Delayed graft function is an early complication leading to impaired creatinine clearance, urine formation and determinant of long term graft outcome. The aim of the present study was to determine the earliest predictive cut-off value of uKIM-1 level in patients with delayed graft function and acute tubular necrosis.
  
  
  METHODS
  We have determined the serial urinary KIM-1 normalized to urinary creatinine (uKIM-1, pg/mg) level at 0, 6, 12, 18, 24 and 48 h of post-transplant by ELISA methods.
  
  
  RESULTS
  The normalized uKIM-1 and AUC-ROC, of uKIM-1 were progressively increased up to 48 h in both delayed graft function (DGF) and immediate graft function (IGF). The u KIM-1 values were significantly high at 6, 12, 18, 24 and 48 h in patients with DGF as compared to that of IGF except at half an hour post-transplant values. Although, progressive increase in uKIM-1 values were observed in both groups of patients; there was an overlap of values between two groups up to 12 h. The earliest non-overlapping values of uKIM-1 between the groups were observed at 18 h onwards and minimum difference of 923.43 pg/mg. The earliest predictive AUC-ROC of uKIM-1 in patients with DGF without overlap with IGF was also observed at 18 h post-transplant with specificity of 100% and sensitivity of 89.9%.
  
  
  CONCLUSIONS
  Serial uKIM-1 measurement can be used as non-invasive diagnostic biomarkers to predict the incident of DGF in living donor renal transplant recipients. At 18(th) post-transplant hour uKIM-1 can predict DGF with 100% specificity and 89.9% sensitivity with a cut-off value of normalized KIM-1 of 923.43 pg/mg.
authors.affiliation: Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical sciences, Lucknow, India.
authors.forename: Brijesh
authors.initials: B
authors.lastname: Yadav
authors.affiliation: Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical sciences, Lucknow, India.
authors.forename: Narayan
authors.initials: N
authors.lastname: Prasad
authors.affiliation: Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical sciences, Lucknow, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Agrawal
authors.affiliation: Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical sciences, Lucknow, India.
authors.forename: Akhilesh
authors.identifier: http://orcid.org/0000-0002-1356-6332
authors.initials: A
authors.lastname: Jaiswal
authors.affiliation: Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical sciences, Lucknow, India.
authors.forename: Vinita
authors.initials: V
authors.lastname: Agrawal
authors.affiliation: Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical sciences, Lucknow, India.
authors.forename: Mohit
authors.initials: M
authors.lastname: Rai
authors.affiliation: Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical sciences, Lucknow, India.
authors.forename: Raj
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical sciences, Lucknow, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical sciences, Lucknow, India.
authors.forename: Dharmendra
authors.initials: D
authors.lastname: Bhadauria
authors.affiliation: Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical sciences, Lucknow, India.
authors.forename: Anupama
authors.initials: A
authors.lastname: Kaul
mesh_terms: D064591:Allografts; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine; D051799:Delayed Graft Function / Q000175:diagnosis / Q000209:etiology / Q000652:urine*; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D007683:Kidney Tubular Necrosis, Acute / Q000175:diagnosis / Q000209:etiology / Q000652:urine*; D019520:Living Donors; D008562:Membrane Glycoproteins / Q000652:urine*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D011991:Receptors, Virus; D015203:Reproducibility of Results; D013997:Time Factors; D016896:Treatment Outcome; D016482:Urinalysis
chemical_list: D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D008562:Membrane Glycoproteins; D011991:Receptors, Virus
keywords: acute tubular necrosis; delayed graft function; immediate graft function; kidney injury molecule-1; post transplant hours