Читать книгу Acute Kidney Injury - Basic Research and Clinical Practice - Группа авторов - Страница 43

KIM-1 is a type 1 transmembrane glycoprotein, which may be measured at the point of care. KIM-1 expression is upregulated in response to ischaemic injury to the kidneys and may have a role in the remodelling of kidneys through signalling of apoptotic renal tubular cells and their subsequent phagocytosis [41]. While KIM-1 is a marker of renal injury, it also exhibits the ability to predict AKI. Interestingly, in a study on 123 patients, KIM-1 was found to be elevated pre-operatively in patients who subsequently developed AKI and elevated urinary KIM-1 has also been shown to be associated with a higher risk of mortality [42, 43]. Meta-analysis of 11 studies (4 of which followed patients undergoing CPB) estimated an AUROC of 0.86 for AKI prediction using KIM-1 values 2–6 h post insult. In keeping with NGAL, KIM-1 appears to perform better in infants and children rather than in adults, as data derived from an adult surgical cohort demonstrates where the derived AUROC was 0.72 [38, 44].