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Urinary KIM-1 in children undergoing nephrotoxic antineoplastic treatment: a prospective cohort study

Danielle Carvalho Pedrosa1, Fernanda Macedo de Oliveira Neves1, Gdayllon Cavalcante Meneses2

  • 1Medical Sciences Post-graduate Program, Department of Clinical Medicine, Universidade Federal do Ceará, Avenue Abolição, 4043, Fortaleza, Ceará, Brazil.

Pediatric Nephrology (Berlin, Germany)
|August 8, 2015
PubMed
Abstract

Insights

Urinary kidney injury molecule-1 (KIM-1) can detect acute kidney injury (AKI) early in children receiving chemotherapy. This renal biomarker shows potential for identifying nephrotoxic treatment complications in pediatric cancer patients.

Area of Science:

  • Pediatric Nephrology
  • Oncology
  • Biomarker Research

Background:

  • Acute kidney injury (AKI) is a common and serious complication in pediatric cancer patients, often caused by nephrotoxic chemotherapy.
  • Current diagnostic methods for AKI may not be sensitive enough for early detection in this vulnerable population.
  • There is a lack of research on renal biomarkers for monitoring AKI in children undergoing chemotherapy.

Purpose of the Study:

  • To evaluate the potential of urinary kidney injury molecule-1 (KIM-1) as an early biomarker for acute kidney injury (AKI) in children receiving nephrotoxic chemotherapy.
  • To assess the ability of urinary KIM-1 to predict persistent renal impairment following chemotherapy treatment.

Main Methods:

  • A prospective study involving pediatric patients treated with methotrexate (MTX) or platinum-based chemotherapy.
  • Urinary KIM-1 levels were measured 24 hours post-chemotherapy initiation.
  • Serum creatinine (sCr) was monitored at multiple time points before and after treatment.

Main Results:

  • 21 out of 64 children (32.8%) developed AKI, predominantly stage 1.
  • Median urinary KIM-1 levels were significantly higher in children with AKI compared to those without (p < 0.01).
  • Urinary KIM-1 demonstrated good discrimination for AKI (AUC 0.82) and predicted persistent renal impairment up to three months later.

Conclusions:

  • Urinary KIM-1, measured 24 hours after chemotherapy initiation, shows promise for early AKI detection in pediatric patients.
  • This biomarker can help identify children at risk of developing acute kidney injury from MTX or platinum-class drugs.
  • Urinary KIM-1 may aid in the timely management of nephrotoxicity in pediatric cancer treatment.
Keywords:
Acute kidney injuryBiomarkersDiagnostic capacityMethotrexateNephrotoxic chemotherapyPlatinum-class drugsUrinary kidney injury molecule-1

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