RGD Reference Report - High urinary excretion of kidney injury molecule-1 is an independent predictor of end-stage renal disease in patients with IgA nephropathy. - Rat Genome Database

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High urinary excretion of kidney injury molecule-1 is an independent predictor of end-stage renal disease in patients with IgA nephropathy.

Authors: Peters, HP  Waanders, F  Meijer, E  Van den Brand, J  Steenbergen, EJ  Van Goor, H  Wetzels, JF 
Citation: Peters HP, etal., Nephrol Dial Transplant. 2011 Nov;26(11):3581-8. doi: 10.1093/ndt/gfr135. Epub 2011 Apr 5.
RGD ID: 7245983
Pubmed: PMID:21467131   (View Abstract at PubMed)
DOI: DOI:10.1093/ndt/gfr135   (Journal Full-text)

BACKGROUND: The variable course of immunoglobulin A nephropathy (IgAN) warrants accurate tools for the prediction of progression. Urinary kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) are markers for the detection of early tubular damage caused by various renal conditions. We evaluated the prognostic value of these markers in patients with IgAN. METHODS: We included patients (n = 65, 72% male, age 43 +/- 13 years) with biopsy-proven IgAN, who were evaluated for proteinuria. Urinary KIM-1 and NGAL were measured by enzyme-linked immunosorbent assay. We analysed data using Cox regression for the outcome end-stage renal disease (ESRD). RESULTS: Median serum creatinine was 142 mumol/L and proteinuria 2.2 g/day. During follow-up (median 75 months), 23 patients (35%) developed ESRD. In patients with IgAN median urinary KIM-1 excretion was 1.7 ng/min and NGAL excretion was 47 ng/min, both significantly higher than in healthy controls. KIM-1 and NGAL were correlated with proteinuria (r = 0.40 and 0.34, respectively, P < 0.01) and each other (r = 0.53, P < 0.01) but not with estimated glomerular filtration rate (eGFR). Interestingly, KIM-1 was not significantly correlated with the excretion of alpha(1)-microglobulin (alpha(1)m) and beta(2)-microglobulin (beta(2)m), known markers of tubular injury. Univariate analysis showed that baseline serum creatinine and urinary excretion of total protein, alpha(1)m, beta(2)m, immunoglobulin G, KIM-1 and NGAL were significantly associated with ESRD. By multivariate analysis, serum creatinine and KIM-1 excretion proved to be significant independent predictors of ESRD. CONCLUSION: KIM-1 and NGAL excretion are increased in patients with IgAN and correlate with proteinuria but not with eGFR. Baseline serum creatinine and urinary KIM-1, but not proteinuria, are independent predictors of ESRD.

RGD Manual Disease Annotations    Click to see Annotation Detail View
TermQualifierEvidenceWithReferenceNotesSourceOriginal Reference(s)
IgA glomerulonephritis  IEP 7245983; 7245983protein:increased expression:urine:RGD 
IgA glomerulonephritis  ISOHAVCR1 (Homo sapiens)7245983; 7245983protein:increased expression:urine:RGD 
IgA glomerulonephritis  ISOLCN2 (Homo sapiens)7245983; 7245983protein:increased expression:urine:RGD 

Objects Annotated

Genes (Rattus norvegicus)
Havcr1  (hepatitis A virus cellular receptor 1)
Lcn2  (lipocalin 2)

Genes (Mus musculus)
Havcr1  (hepatitis A virus cellular receptor 1)
Lcn2  (lipocalin 2)

Genes (Homo sapiens)
HAVCR1  (hepatitis A virus cellular receptor 1)
LCN2  (lipocalin 2)


Additional Information