title: Urine KIM-1 as a Potential Biomarker of Acute Renal Injury After Circulatory Collapse in Children.
abstract: OBJECTIVE
  Serum creatinine (SCr) is a late marker of acute kidney injury (AKI) due to the lag time between initiating injury and loss of function. We assessed the ability of urinary interleukin-18 (IL-18), kidney injury molecule-1 (KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL) to predict AKI in critically ill children with circulatory collapse.
  
  
  METHODS
  Serum creatinine, estimated creatinine clearance (eCrCL), urine IL-18, KIM-1, and NGAL values were measured in 86 children with circulatory collapse on the day of admission, and the results were compared with those obtained 6 days later. Acute kidney injury was defined as a decrease in eCrCL of greater than 25% within the first 48 hours of enrollment. Areas under the curve (AUC) for receiver operating characteristic curve were calculated for the early detection of AKI.
  
  
  RESULTS
  Mean SCr concentration did not differ significantly during the first 6 days of hospital admission. In contrast, mean urine concentrations of IL-18, KIM-1, and NGAL rose significantly from day of admission to the sixth day of hospital stay (P < 0.001). Urinary KIM-1 emerged as having the strongest performance for the early detection of AKI, followed by NGAL, IL-18, and eCrCL. Urinary KIM-1 displayed the highest AUC of 0.81 (95% confidence interval [CI], 0.76-0.93; P < 0.001) for the early detection of AKI after circulatory collapse, followed by NGAL (0.77% CI, 0.70-0.84) and IL-18 (0.69% CI, 0.48-0.64).
  
  
  CONCLUSIONS
  Of a panel of 3 promising urinary biomarkers, KIM-1 demonstrated the best performance in predicting AKI in children with circulatory collapse before a change in SCr or eCrCL becomes apparent.
authors.forename: Farahnak
authors.initials: F
authors.lastname: Assadi
authors.affiliation: Department of Pediatrics, Section of Nephrology, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Fatemeh Ghane
authors.initials: FG
authors.lastname: Sharbaf
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D000293:Adolescent; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D000072596:Hepatitis A Virus Cellular Receptor 1 / Q000378:metabolism*; D006801:Humans; D007223:Infant; D020382:Interleukin-18 / Q000652:urine; D000071068:Lipocalin-2 / Q000652:urine; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D012769:Shock / Q000150:complications*
chemical_list: D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; C000589760:IL18 protein, human; D020382:Interleukin-18; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D003404:Creatinine