Kidney injury molecule-1 expression in transplant biopsies is a sensitive measure of cell injury

Kidney Int. 2008 Mar;73(5):608-14. doi: 10.1038/ Epub 2007 Dec 26.


Kidney injury molecule-1 (KIM-1) is a specific histological biomarker for diagnosing early tubular injury on renal biopsies. In this study, KIM-1 expression was quantitated in renal transplant biopsies by immunohistochemistry and correlated with renal function. None of the 25 protocol biopsies showed detectable tubular injury on histologic examination, yet 28% had focal positive KIM-1 expression. Proximal tubule KIM-1 expression was present in all biopsies from patients with histological changes showing acute tubular damage and deterioration of kidney function. In this group, higher KIM-1 staining predicted a better outcome with improved blood urea nitrogen (BUN), serum creatinine, and estimated glomerular filtration rate (eGFR) over an ensuing 18 months. KIM-1 was expressed focally in affected tubules in 92% of kidney biopsies from patients with acute cellular rejection. By contrast, there was little positive staining for Ki-67, a cell proliferation marker, in any of the groups. KIM-1 expression significantly correlated with serum creatinine and BUN, and inversely with the eGFR on the biopsy day. Our study shows that KIM-1 staining sensitively and specifically identified proximal tubular injury and correlated with the degree of renal dysfunction. KIM-1 expression is more sensitive than histology for detecting early tubular injury, and its level of expression in transplant biopsies may indicate the potential for recovery of kidney function.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Animals
  • Biopsy
  • Female
  • Graft Rejection / diagnosis*
  • Graft Rejection / pathology
  • Hepatitis A Virus Cellular Receptor 1
  • Humans
  • Kidney Diseases / diagnosis*
  • Kidney Diseases / pathology
  • Kidney Transplantation*
  • Kidney Tubules, Proximal / chemistry*
  • Kidney Tubules, Proximal / pathology
  • Male
  • Membrane Glycoproteins / analysis*
  • Middle Aged
  • Receptors, Virus / analysis*


  • HAVCR1 protein, human
  • Hepatitis A Virus Cellular Receptor 1
  • Membrane Glycoproteins
  • Receptors, Virus