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Volume 8
Journal of Clinical & Experimental Pathology
Pathology Summit 2018
July 02-03, 2018
July 02-03, 2018 Bangkok, Thailand
15
th
Global Experts Meeting on
Pathology and Laboratory Medicine
Level of human Kidney Injury Molecule-1 (KIM-1) as an early marker for diabetic nephropathy in
Egyptian type-2 diabetic patients
Hoda Ali Mohamed El-Attar, Khalil G I and Gaber E W
Alexandria University, Egypt
Background:
Human Kidney Injury Molecule-1 (KIM-1) is produced in the affected segments of the proximal renal tubule
whenever there is a pathophysiological state resulting in dedifferentiation of the epithelium. The kidney injury molecule-1
is a type-1 transmembrane glycoprotein (339 aa). KIM-1 ectodomain is cleaved and shed in a metalloproteinase-dependent
fashion. The soluble KIM-1 protein that appears in the urine of humans is about 90 KDa. All forms of chronic kidney disease,
including diabetes are associated with tubulo-interstitial injury.
Aim:
The current study was performed try to assess use of urinary KIM-1/Creatinine ratio as a sensitive diagnostic tool for
renal injury in the urine of patients with type-2 diabetic Egyptian patients.
Methods:
Eighty (80) subjects were subjected to clinical examination included and subdivided as 20 apparently healthy
control volunteers (group-1) and 60 diabetic patients which were divided into 3 subgroups (Group-2, Group-3 and Group-4)
of 20 patients each: According to ACR: (ACR<30 mg/g, 30-299 mg/g and ≥300 mg/g respectively). All were subjected to
laboratory investigations which included: Morning mid-stream urine sample for: (1) Complete urine analysis, (2) quantitative
measurement of urinary albumin, (3) urinary creatinine, (4) calculation of urinary albumin to creatinine ratio, (5) measurement
of KIM-1 (ELISA), and (6) calculation of KIM-1 to creatinine ratio.
Results:
Urinary KIM-1 levels were increased with the progression of nephropathy. Urinary KIM-1 levels were independent
risk factor of eGFR and albuminuria in diabetic patients. Urinary KIM-1/Cr ratio was more sensitive than KIM-1. There was
no correlation between urinary KIM-1/Cr ratio and GFR in all studied groups.
Conclusion:
Urinary KIM-1/Cr ratio is a sensitive, noninvasive diagnostic tool for kidney affection in type-2 diabetic Egyptian
patients that seem to predict renal injury in early period independent of albuminuria. Due to lack of correlation, both KIM-1/
Cr and Alb/Cr ratios are required to be calculated for type-2 diabetic patients.
Recommendations:
The use of KIM-1/Cr ratio as a diagnostic tool for kidney affection by measuring it in urine of type-2
diabetic patients at risk of chronic kidney disease.
hoda.ali55151@yahoo.comJ Clin Exp Pathol 2018, Volume 8
DOI: 10.4172/2161-0681-C2-049