Dynamic variation of kidney injury molecule-1 mRNA and protein expression in blood and urine of renal transplant recipients: a cohort study

Clin Exp Nephrol. 2019 Oct;23(10):1235-1249. doi: 10.1007/s10157-019-01765-y. Epub 2019 Jul 13.


Background: Acute renal dysfunction still constitutes a highly significant obstacle to renal transplantation outcome. Kidney injury molecule-1 is highly upregulated in proximal tubular cells and shed into the urine and blood circulation following kidney injury. The aim of current cohort study was to evaluate the urine KIM-1 (uKIM-1) mRNA expression level and its protein concentration in blood and urine samples to determine whether sequential monitoring of KIM-1 in renal allograft recipients is a reliable biomarker for predicting the clinical status and outcome.

Methods: Both uKIM-1 mRNA expression level and the level of serum and uKIM-1 protein concentration in the 52 renal transplant recipients were respectively quantified using real-time PCR and ELISA methods at 2, 90 and 180 days after transplantation.

Result: KIM-1 mRNA and protein expression level in the blood and urine samples of patients with graft dysfunction was significantly higher than patients with well-functioning graft on days 2, 90 and 180 after transplantation. Receiver-operating characteristic curve analysis of mRNA and protein expression levels showed that urinary and blood KIM-1 at months 3 and 6 could predict acute renal dysfunction at 6 months and 1 year after transplantation.

Conclusion: Sequential monitoring of uKIM-1 mRNA expression level and its protein concentration in the serum and urine samples of renal transplant patients suggests that KIM-1 could be a sensitive and specific biomarker for early diagnosis and prognosis of kidney allograft injury.

Keywords: Graft dysfunction; KIM-1; Renal transplantation.

MeSH terms

  • Adult
  • Aged
  • Biomarkers
  • Cohort Studies
  • Early Diagnosis
  • Female
  • Graft Rejection / diagnosis
  • Graft Rejection / metabolism
  • Hepatitis A Virus Cellular Receptor 1 / blood
  • Hepatitis A Virus Cellular Receptor 1 / metabolism*
  • Humans
  • Kidney Function Tests
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • RNA, Messenger / blood
  • RNA, Messenger / genetics
  • RNA, Messenger / urine
  • Sensitivity and Specificity
  • Treatment Outcome


  • Biomarkers
  • HAVCR1 protein, human
  • Hepatitis A Virus Cellular Receptor 1
  • RNA, Messenger