eISSN: 1644-4124
ISSN: 1426-3912
Central European Journal of Immunology
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3/2019
vol. 44
 
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abstract:
Clinical immunology

Prognostic value of serum and urine kidney injury molecule-1 in infants with urinary tract infection

Grażyna Krzemień
1
,
Agnieszka Turczyn
1
,
Małgorzata Pańczyk-Tomaszewska
1
,
Iwona Kotuła
2
,
Urszula Demkow
2
,
Agnieszka Szmigielska
1

  1. Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland
  2. Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland
(Centr Eur J Immunol 2019; 44 (3): 262-268)
DOI: https://doi.org/10.5114/ceji.2019.89600
Online publish date: 2019/09/30
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Introduction
Kidney injury molecule-1 (KIM-1) is an important diagnostic and prognostic marker in acute kidney injury and chronic kidney disease of various aetiologies. The aim of the study was to evaluate the usefulness of serum KIM-1 (sKIM-1) and urine KIM-1 (uKIM-1) for predicting febrile and non-febrile urinary tract infection (UTI) in infants.

Material and methods
A prospective study included 101 children divided into three groups: febrile UTI 49 children, non-febrile UTI 22 children, and healthy controls 30 children. The following laboratory tests were performed: sKIM-1, uKIM-1, white blood count (WBC), C-reactive protein (CRP), and procalcitonin (PCT).

Results
Median levels of sKIM-1 were significantly higher in the febrile and non-febrile UTI group compared to the healthy controls (both p < 0.05). Mean levels of uKIM-1 were significantly lower in the febrile UTI group compared to the non-febrile UTI group and healthy controls (p < 0.001 and p < 0.0001, respectively). Univariate logistic regression analysis has demonstrated a positive association of sKIM-1 with febrile and non-febrile UTI (both p < 0.05), and negative association uKIM-1 with febrile UTI (p < 0.0001). Receiver operating curve (ROC) analysis showed good diagnostic profiles of uKIM-1 with a best cut-off value of 2.4 ng/ml and sKIM-1 with a best cut-off value of 3.88 ng/ml for predicting febrile UTI (area under the curve [AUC] 0.82 and 0.67, sensitivity 73% and 63%, specificity 86% and 80%, respectively).

Conclusions
sKIM-1 can be useful for predicting febrile UTI. We do not recommended use of uKIM-1 as a marker of febrile UTI because of its negative association with febrile UTI. Both markers are not useful for predicting non-febrile UTI.

keywords:

children, biomarkers, acute kidney injury, urinary tract infection, kidney injury molecule-1
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