Kidney Week

Abstract: FR-PO580

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

Session Information

• Glomerular Diseases: Lupus and Vasculitis
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1302 Glomerular Diseases: Immunology and Inflammation

Authors

• Brilland, Benoit, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Benoit Brilland,

• Boud'hors, Charlotte, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Charlotte Boud'hors,

• Wacrenier, Samuel, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Samuel Wacrenier,

• Blanchard, Simon, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Simon Blanchard,

• Blanchet, Odile, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Odile Blanchet,

• Piccoli, Giorgina B., Centre Hospitalier du Mans, Le Mans, Pays de la Loire, France

Giorgina B. Piccoli,

• Henry, Nicolas, CH Laval, Laval, France

Nicolas Henry,

• Djema, Assia Ilham, Centre Hospitalier de Cholet, Cholet, France

Assia Ilham Djema,

• Jeannin, Pascale, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Pascale Jeannin,

• Delneste, Yves, Universite Angers Faculte des sciences, Angers, Pays de la Loire, France

Yves Delneste,

• Copin, Marie-Christine, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Marie-Christine Copin,

• Augusto, Jean francois, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Jean francois Augusto,

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.