title: Urinary KIM-1: a novel biomarker for evaluation of occupational exposure to lead.
abstract: Chronic occult lead poisoning often develops ensuing occupational lead exposure. Early diagnosis of lead poisoning is critical for timely discontinuation of lead exposure and for prognosis. This study explored the value of urinary kidney injury molecule-1 (KIM-1) in diagnosing renal injury induced by lead at an early stage. We retrospectively analyzed 92 workers exposed to occupational lead and demonstrated a better correlation ship between blood lead levels and urine excretion of KIM-1 than other traditional renal injury biomarkers following creatinine adjustment. Receiver operating characteristic curve analysis of the ability of diverse biomarkers for predicting kidney injury in lead-exposed workers demonstrated that the order of predicting accuracy of the studied biomarkers is as follows: urinary KIM-1-to-creatinine ratio > urinary N-acetyl-β-(D)-glucosaminidase-to-creatinine ratio > urinary β2-microglobulin-to-creatinine ratio > urinary α1-microglobulin-to-creatinine ratio, with the Youden index being 16.59 ng/g, 14.01 U/g, 0.15 mg/g, and 4.63 mg/g, respectively. Collectively, our findings suggest that short-period occupational lead exposure may cause injury of renal tubules. Urinary excretion of KIM-1 correlates with blood lead levels better than other traditional renal injury biomarkers, including N-acetyl-β-(D)-glucosaminidase, α1-microglobulin, and β2-microglobulin. Longitudinal surveillance of urinary KIM-1 may aid for early diagnosis of renal tubular injury in workers with occupational lead exposure.
authors.affiliation: Department of Nephrology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhou
authors.affiliation: Department of Nephrology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Yahong
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Nephrology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Nephrology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Han
authors.affiliation: Department of Nephrology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Nephrology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Xuefang
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Occupational medicine, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Xingya
authors.initials: X
authors.lastname: Kuang
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000652:urine; D003404:Creatinine / Q000652:urine; D005260:Female; D000072596:Hepatitis A Virus Cellular Receptor 1 / Q000378:metabolism*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000652:urine*; D007854:Lead / Q000633:toxicity*; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D007854:Lead; D003404:Creatinine