Receiver Operating Characteristic Curves Reveal Kidney Injury Molecule-1 Being Sensitive For Identifying Acute Tubular Injury

Document Type

Conference Proceeding

Publication Date

9-2019

Publication Title

Archives of Pathology and Laboratory Medicine

Abstract

Context: Kidney injury molecule-1 (KIM-1) staining has been shown to be useful in identifying acute proximal tubular injury, but its sensitivity and specificity in correlation with serum creatinine (sCr) have not been well established in renal biopsies. Design: We randomly selected 184 renal biopsies (children younger than 20 years and adults) with acute renal diseases. Patients’ sCr levels were obtained, and the renal biopsies were immunostained for KIM-1. Spearman correlation between sCr and KIM-1 scores was computed, and receiver operating characteristic (ROC) curves were used to examine the sensitivity and specificity of using sCr to predict KIM-1 scores. Results: KIM-1 staining scores were significantly correlated with sCr levels (P , .05) in all age groups. The ROC curve showed the area under the curve (AUC) in pediatric cases was 0.74, which demonstrated KIM1 as a fair index in correlating with sCr (median sensitivity, 82%; specificity, 43%). In adults, the AUC was 0.87 (median sensitivity, 83%; specificity, 53%), indicating that KIM-1 was an even better index in the adults (Figure 49). Conclusions: We found that positive KIM-1 was significantly correlated with elevated sCr levels, and this correlation was categorized as ‘‘good’’ when plotted on a ROC curve in adults. Therefore, KIM-1 staining is a sensitive marker in identifying acute tubular injury.

Volume

143

Issue

9

First Page

e89

Comments

College of American Pathologists Annual Meeting, September 21-25, 2019, Orlando, FL

Last Page

e90

DOI

10.5858/arpa.2019-0901-AB

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