title: Is Kidney Injury Molecule 1 a Valuable Tool for the Early Diagnosis of Contrast-Induced Nephropathy?
abstract: Contrast-induced nephropathy (CIN) is a common complication of diagnostic/therapeutic procedures. Serum creatinine levels are sensitive but often lead to diagnostic delays in acute kidney injury and potential misclassification of actual injury status. Kidney injury molecule (KIM-1) is a novel early marker of acute kidney injury. The aim of our study was to evaluate the KIM-1 levels in patients with CIN. We performed a single-center, nested case-control study.
  
  
  METHODS
  Three thousand two hundred patients who had undergone coronary angiography were included in the study. Thirty-two patients were diagnosed with CIN. Twenty patients who had undergone coronary angiography but did not have CIN were evaluated as a control group (n = 20). The diagnosis of CIN was performed according to the KDIGO 2012 Acute Kidney Injury Guideline criteria. Urinary KIM-1 levels were measured by enzyme-linked immunosorbent assay before as well as on the 6th and 48th hours of contrast exposure. Serum creatinine levels were measured before as well as on the 24th and 48th hours after angiographic procedure.
  
  
  RESULTS
  We demonstrated that KIM-1 levels increased in the patients with CIN significantly on the sixth hour when compared with the baseline (P < 0.01; median levels, 0.27 and 0.70 mg/dL) but not in the controls (P = 0.107). The precontrast and 48th-hour KIM-1 levels were median ones and were also significantly different (P = 0.001, the median levels were 0.27 and 0.60 mg/dL, respectively).
  
  
  CONCLUSIONS
  Because creatinine is a sensitive but a late marker of CIN, KIM-1 may be used for early diagnosis and early initiation of treatment and may reduce risk for morbidity.
authors.affiliation: From the *Department of Internal Medicine, †Department of Biochemistry, ‡Division of Nephrology, Department of Internal Medicine, and §Department of Cardiology, Turgut Ozal University Faculty of Medicine, Ankara, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Akdeniz
authors.forename: Huseyin Tugrul
authors.initials: HT
authors.lastname: Celik
authors.forename: Fatmanur
authors.initials: F
authors.lastname: Kazanci
authors.forename: Hakki
authors.initials: H
authors.lastname: Yilmaz
authors.forename: Serkan
authors.initials: S
authors.lastname: Yalcin
authors.forename: Mukadder Ayse
authors.initials: MA
authors.lastname: Bilgic
authors.forename: Nuket
authors.initials: N
authors.lastname: Ruzgaresen
authors.forename: Ali
authors.initials: A
authors.lastname: Akcay
authors.forename: Beyhan
authors.initials: B
authors.lastname: Eryonucu
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000175:diagnosis* / Q000652:urine*; D000368:Aged; D015415:Biomarkers / Q000652:urine; D016022:Case-Control Studies; D015331:Cohort Studies; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects; D042241:Early Diagnosis; D005260:Female; D000072596:Hepatitis A Virus Cellular Receptor 1 / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D003287:Contrast Media; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1