Scandinavian journal of clinical and laboratory investigation. Supplementum
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Scand. J. Clin. Lab. Invest. Suppl. · Jan 2008
ReviewKidney Injury Molecule-1 (KIM-1): a specific and sensitive biomarker of kidney injury.
There is an urgent need for the detection and monitoring of kidney injury in both the acute and chronic disease setting. Urinary kidney injury molecule-1 (Kim-1), a type-1 transmembrane protein, is not normally present, but is expressed on the proximal tubule apical membrane with injury. Kim-1 has proved to be an outstanding indicator of kidney injury in the rat, outperforming blood urea nitrogen and serum creatinine as predictors of histopathological changes in the proximal tubule in response to many pathophysiological states or toxicants. Studies in man indicate that tissue expression and urinary excretion of the ectodomain of KIM-1 are sensitive and specific markers of injury as well as predictors of outcome.
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Scand. J. Clin. Lab. Invest. Suppl. · Jan 2008
Fatty acid-binding protein as marker for renal injury.
The assessment of biomarkers to detect renal injury has been studied before, but the sensitivity and specificity of urinary and serum profiles of these markers still need to be improved. One of the promising new markers for detection of renal injury is the family of 15 kDa cytoplasmic fatty acid-binding proteins (FABPs). Remarkably, however, the application of FABP as marker for renal injury due to ischaemia, toxic heavy metals or in end-stage renal failure has only recently been investigated. ⋯ Urinary L-FABP has been evaluated recently more explicitly and shows significant elevations in progressive end-stage renal failure as well as after ischaemic injury due to renal transplantation or cardiac bypass surgery. H- and L-FABP have been shown to be useful markers for rapid detection and monitoring of renal injury. Further study of the diagnostic and prognostic use of these FABP types will require further commercialization of automated and rapid assays for proper clinical application.