Clinical utility of urine kidney injury molecule-1 (KIM-1) and gamma-glutamyl transferase (GGT) in the diagnosis of canine acute kidney injury
- 296 Downloads
The aim of the present study was to evaluate the sensitivity and specificity of urine KIM-1 and urine GGT for the detection of naturally-occurring AKI, compared to healthy control dogs, dogs with stable chronic kidney disease (CKD), and dogs with lower urinary tract disorders (LUTD). The study included AKI grade 1 (n = 21), AKI grade 2 to 5 (n = 11), stable CKD (n = 11), LUTD (n = 15), and healthy dogs (n = 37). Urine KIM-1 (ng/mg) and GGT (U/l) were normalized to urine creatinine (uCr). Statistically significant difference in KIM/uCr (p = 0.0007) and GGT/uCr (p < 0.0001) was found among the study groups. Area under the curve (AUC) for KIM-1/uCr and GGT/uCr as predictors of AKI was 0.81 and 0.91 respectively. Values of KIM-1/uCr of 0.73 ng/mg and of GGT/uCr of 54.33 showed the best combination of sensitivity and specificity (75% and 75.6%; 85.7% and 89.1% respectively). A significant positive correlation (p < 0.0001) between KIM-1/uCr and GGT/uCr was found. Both urine KIM-1/uCr and GGT/uCr seemed to be potentially good markers for the diagnosis of AKI. Dogs with AKI showed significantly higher levels of urine KIM-1/uCr and urine GGT/uCr, compared with healthy dogs. Caution should be used in the evaluation of elevated urine KIM-1/uCr and GGT/uCr in dogs with pre-existing CKD and/or LUTD. Urine KIM-1/uCr and GGT/uCr might have a significant clinical utility, as complementary test, particularly in diagnosis early, non-azotemic stages of AKI.
KeywordsKIM-1 GGT AKI Dog
Compliance with ethical standards
Conflict of interest
The Authors declare no conflict of interest. This paper was not supported by grants.
- Palm CA, Segev G, Cowgill LD, Le Roy BE, Kowalkowski KL, Kanakubo K, Westropp JL (2016) Urinary neutrophil gelatinase-associated lipocalin as a marker for identification of acute kidney injury and recovery in dogs with gentamicin-induced nephrotoxicity. J Vet Intern Med 30(1):200–205CrossRefPubMedPubMedCentralGoogle Scholar
- Waikar SS, Sabbisetti V, Arnlov J, Carlsson AC, Coresh J, Feldman HI, Foster MC, Fufaa GD, Helmersson-Karlqvist JH, Hsu CY, Kimmel PL, Larsson A, Liu Y, Lind L, Liu KD, Mifflin TE, Nelson RG, Riservs U, Vasan RS, Xie D, Zhang X, Bonventre JV (2016) Relationship of proximal tubular injury to chronic kidney disease as assessed by urinary kidney injury molecule-1 in five cohort studies. Nephrol Dial Transplant 31:1460–1470CrossRefPubMedPubMedCentralGoogle Scholar