Diagnostic role of kidney injury molecule-1 in renal cell carcinoma

Int Urol Nephrol. 2019 Nov;51(11):1893-1902. doi: 10.1007/s11255-019-02231-0. Epub 2019 Aug 5.


Despite rapid advances in diagnostic and therapeutic medicine, renal cell carcinoma (RCC) continues to cause significant morbidity and mortality in patients. While there has been a shift towards earlier detection, approximately 16% of patients present with metastatic disease at the time of diagnosis. Kidney injury molecule-1 (KIM-1) is a glycoprotein that has been shown to be a robust and reliable biomarker of acute proximal tubular injury. As KIM-1 is mainly expressed in RCC derived from the proximal tubules, it is a reliable marker to differentiate between proximal tubular primary RCC and distal nephron primary RCC. Several studies have investigated urinary KIM-1 (uKIM-1) in RCC and demonstrated that it is a sensitive and specific marker for detecting localized RCC, as patients had markedly reduced uKIM-1 levels following nephrectomy, with uKIM-1 levels correlating with tumor size and grade. In addition, levels of KIM-1 present in plasma have also shown utility as a biomarker of RCC with levels being elevated in RCC cases at least 5 years before diagnosis. This review focuses on a progressive understanding of KIM-1 in the diagnosis of RCC using biopsies, urine, and plasma samples, and it will also provide some insight into potential roles of KIM-1 in the growth and spread of RCC.

Keywords: Immunohistochemical staining; Kidney injury molecule-1; Renal cell carcinoma; Urine and plasma analysis.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / urine*
  • Carcinoma, Renal Cell / blood
  • Carcinoma, Renal Cell / diagnosis*
  • Carcinoma, Renal Cell / etiology
  • Carcinoma, Renal Cell / urine*
  • Diagnosis, Differential
  • Hepatitis A Virus Cellular Receptor 1 / analysis*
  • Hepatitis A Virus Cellular Receptor 1 / blood
  • Hepatitis A Virus Cellular Receptor 1 / physiology
  • Humans
  • Kidney Neoplasms / blood
  • Kidney Neoplasms / diagnosis*
  • Kidney Neoplasms / etiology
  • Kidney Neoplasms / urine*


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