Effectiveness of Urinary Kidney Injury Molecule-1 to diagnose Subclinical Acute Kidney Injury induced by Extracorporeal Shock Wave Lithotripsy

Abstract

Objective: To find the effectiveness of Kidney Injury Molecule-1 (KIM-1) as biomarker in diagnosing Extracor-
poreal Shock Wave Lithotripsy (ESWL) induced renal damage by taking serum creatinine concentration as
gold standard
Materials and Method: In this interventional study, a total of (80) diagnosed patients of nephrolithiasis
undergoing ESWL of age ≥ (18) years were enrolled from the Outpatient Department of Mayo Hospital, Lahore.
After informed consent, urine and whole blood samples were drawn pre and post ESWL. Samples after centri-
fugation were analyzed for urinary KIM-1 levels employing sandwich ELISA technique. While serum creatinine
levels were measured by colorimetric photometry in the Advanced Research Lab of Biomedical Sciences,
King Edward Medical University, Lahore.
Results: Of (80) patients, 53 (66.3%) of them were males and 27 (33.8%) were femaless. Serum creatinine
levels were decreased by 0.15 times from the baseline after procedure of ESWL but remained within normal
clinical range. Whereas urinary KIM-1 levels were raised 2.04 times than the baseline after ESWL (p< 0.001)
depicting subclinical acute kidney injury. At a cut off value of >50.9pg/ml, urinary KIM-1 had a 71.25%
sensitivity and 46.25% specificity with AUC of 0.699 (p<0.001) to predict acute kidney injury after ESWL. A
strong positive correlation (r= 0.62, p<0.001) was found between pre and post ESWL values of KIM-1.
Conclusion: The noninvasive biomarker KIM-1 was observed more effective in our study for diagnosing ESWL–induced subclinical acute kidney injury than serum creatinine.