Urinary Kidney Injury Molecule-1(Kim-1) As an Early Predictor of Acute Kidney Injury After Cardiopulmonary Bypass

Ali, Salah A.I.; Ahmed, Hanan S.; Atef, Rehab M.; Brik, Alaa; Mohamed Ismail Ali, Israa Ahmady; Soliman, Ahmad Sallam

doi:10.21608/zumj.2025.394242.4003

Urinary Kidney Injury Molecule-1(Kim-1) As an Early Predictor of Acute Kidney Injury After Cardiopulmonary Bypass

Document Type : Original Article

Authors

¹ Assistant Professor of Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt

² Professor of Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt

³ Professor of Cardiothoracic Department, Faculty of Medicine, Zagazig University, Egypt

⁴ Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt

10.21608/zumj.2025.394242.4003

Abstract

Background: Acute Kidney Injury (AKI) is a common complication post-cardiac surgery, influenced by factors like reduced renal blood flow during CPB and inflammatory mediators damaging renal tubular epithelium. This study aimed to evaluates urinary Kidney Injury Molecule 1 (KIM-1) as an early predictor of acute kidney injury in open heart patients after Post-Cardiopulmonary Bypass. Methods: This was an observational follow up prospective cohort study design was done in the clinical pathology and Cardiothoracic Surgery Departments at Zagazig University for one year, where the enrolled 48 cardiac patients who had undergone open heart surgery with cardiopulmonary bypass and fulfilled the inclusion and exclusion criteria of the study, were laboratory investigation, Kidney function tests (BUN and creatinine). An enzyme-linked immunoassay (ELISA) kit was used to determine urinary KIM-1, and KDIGO-guided postoperative monitoring was conducted to check for acute kidney injury. Results: A cutoff value of ≥916.64 for KIM-1 at 3 hours postoperatively showed high sensitivity (94.7%) and specificity (93.1%) for predicting AKI. Similarly, KIM-1 ≥944.697 at 24 hours postoperatively had a sensitivity of 100% and specificity of 86.2%. AKI incidence correlated significantly with CPB duration and cross-clamp time but showed no significant association with demographic factors or comorbidities. Conclusion The findings suggest that KIM-1 is a promising early biomarker for AKI detection post-CPB surgery.

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