Urinary Kidney Injury Molecule – 1 a Marker of Kidney Injury in Renal Transplant patients

INTRODUCTION: Kidney transplantation remains the treatment of choice for end-stage renal disease patients and the most effective form of renal replacement therapy in terms of long-term survival and quality of life. Early diagnosis of renal allograft dysfunction is crucial for management of patients with transplanted kidney. AIM OF THE STUDY: To determine the role of urinary kidney injury molecule – 1 in assessing the severity of the renal injury in renal transplant recipients. MATERIALS AND METHODS: This is a case control study comprised of a total number of 90 human subjects. Group A: 45 unrelated individuals with renal transplant recipients, attending the outpatient department of nephrology. Group B: 45 age and sex matched healthy controls. In the KDIGO guidelines, based on the fluctuant serum creatinine level i.e., ≥ 0.3 mg/dL within 48 hours, the renal transplant recipients and controls were divided into those with kidney injury (serum creatinine rise ≥ 0.3 mg/dL) and those without kidney injury (serum creatinine rise < 0.3 mg/dL. Urinary Kidney injury molecule – 1 (KIM – 1) was measured by sandwich ELISA method. Serum creatinine, blood urea, urine protein-creatinine ratio, serum calcium and phosphorus, lipid profile were estimated. eGFR calculated based of CKD-EPI formula. RESULTS: The mean urine KIM – 1 level in renal transplant recipients with kidney injury is higher than mean urine KIM – 1 level in renal transplant recipients and controls without kidney injury (p value of 0.020). ROC curve plotted for KIM-1 showed p value of 0.025, the cut off for urine KIM-1 level to diagnose kidney injury is 4.26 ng/dL with sensitivity of 66.7% and specificity of 78.8%. CONCLUSION: Urinary kidney injury molecule – 1 is an early biomarker of kidney injury, it facilitates early diagnosis of kidney injury and management strategies, thereby reducing morbidity and mortality in renal transplant recipients