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Abstract: FR-PO580

Kidney Injury Molecule 1 (KIM-1): A Potential Biomarker of AKI and Tubulointerstitial Injury in Patients With ANCA-Glomerulonephritis

Session Information

Category: Glomerular Diseases

  • 1302 Glomerular Diseases: Immunology and Inflammation

Authors

  • Brilland, Benoit, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Boud'hors, Charlotte, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Wacrenier, Samuel, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Blanchard, Simon, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Blanchet, Odile, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Piccoli, Giorgina B., Centre Hospitalier du Mans, Le Mans, Pays de la Loire, France
  • Henry, Nicolas, CH Laval, Laval, France
  • Djema, Assia Ilham, Centre Hospitalier de Cholet, Cholet, France
  • Jeannin, Pascale, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Delneste, Yves, Universite Angers Faculte des sciences, Angers, Pays de la Loire, France
  • Copin, Marie-Christine, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Augusto, Jean francois, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
Background

Kidney injury molecule 1 (KIM-1) is a transmembrane glycoprotein expressed by proximal tubular cells, recognized as an early, sensitive, and specific urinary biomarker for kidney injury. Blood KIM-1 was recently associated with the severity of acute and chronic kidney damage but its value in ANCA-associated vasculitis with glomerulonephritis (ANCA-GN) has not been studied. Thus, we analyzed its expression at ANCA-GN diagnosis and its relationship with clinical presentation, kidney histopathology, and early outcomes.

Methods

We assessed KIM-1 levels and other pro-inflammatory molecules (CRP, IL-6, TNF-α, MCP-1 and PTX3) at ANCA-GN diagnosis and after 6 months in patients included in the Maine-Anjou registry, which gathers data patients from four French Nephrology Centers diagnosed since January 2000.

Results

Blood KIM-1 levels were assessed in 58 patients. Levels were elevated at diagnosis and decreased after induction remission therapy. KIM-1 was associated with the severity of renal injury at diagnosis and the need for KRT. In opposition to other pro-inflammatory molecules, KIM-1 correlated with the amount of interstitial fibrosis and tubular atrophy (IF/TA) on kidney biopsy, but not with glomerular involvement. In multivariable analysis, elevated KIM-1 predicted initial eGFR (β = -19 [-31, -7.6], p = 0.002).

Conclusion

KIM-1 appears as a potential biomarker for acute kidney injury and for tubulointerstitial injury in ANCA-GN. Whether KIM-1 is only a surrogate marker for IF/TA or a key immune player in ANCA-GN pathogenesis remain to be determined.