Predictive Value of Urinary KIM-1, TIMP-2 and sTREM-1 for Contrast-Induced Acute Kidney Injury in Elderly Patients After Percutaneous Coronary Intervention

Wu Huang, Rong Wang, Ping Zhang Department of Geriatric Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, People’s Republic of ChinaCorrespondence: Rong Wang, Department of Geriatric Medicine, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, Hunan, 410011, People’s Republic of China, Tel +86-0731-85295173, Email [email protected]: We aimed to address the predictive value of urinary kidney injury molecule-1 (KIM-1), tissue inhibitor of metalloproteinases-2 (TIMP-2) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for contrast-induced acute kidney injury (CI-AKI) in elderly patients after percutaneous coronary intervention (PCI).Methods: One hundred thirty-six patients who underwent PCI were separated into the CI-AKI group (n = 36) and the non-CI-AKI group (n = 100) based on CI-AKI occurrence after operation, and their general data were collected. Blood and urine specimens were collected before operation (at the time of admission) and 6 h, 12 h, 24 h and 48 h after the operation and preserved for future use. Serum creatinine (Scr) levels were tested and an estimated glomerular filtration rate (eGFR) was counted. Urinary KIM-1, TIMP-2 and sTREM-1 levels were assessed and the preoperative and general data as well as postoperative urinary KIM-1, TIMP-2 and sTREM-1 levels were compared. The early diagnostic value of urinary KIM-1, TIMP-2 and sTREM-1 at 6 hours postoperatively for CI-AKI was analyzed by receiver operating characteristic (ROC) curve.Results: After 48 h of operation, Scr in the CI-AKI group was higher versus the non-CI-AKI group. At 24 h and 48 h postoperatively, eGFR in the CI-AKI group was lower versus the non-CI-AKI group; urinary KIM-1 and sTREM-1 in the CI-AKI group were higher in contrast to the non-CI-AKI group; TIMP-2 in the CI-AKI group was higher versus that in the non-CI-AKI group. ROC curve analysis showed that the areas under the curve (AUCs) for urine KIM-1, TIMP-2, and sTREM-1 in diagnosing CI-AKI at 6 hours postoperatively were 0.852 (95% CI: 0.768– 0.936), 0.810 (95% CI: 0.723– 0.898), and 0.874 (95% CI: 0.804– 0.943), and the cut-off values were 45.93 ng/L, 1.63 ng/mL, and 61.48 ng/L, respectively, with sensitivities of 66.70%, 58.30%, and 72.20%, and specificities of 95.00%, 93.00%, and 91.00%, respectively (all P < 0.05).Conclusion: Urinary KIM-1, TIMP-2 and sTREM-1 can respond to early changes in renal function after PCI and have good application value in the early diagnosis of CI-AKI.Keywords: percutaneous coronary intervention, kidney injury molecule-1, tissue inhibitor of metalloproteinases-2, soluble triggering receptor expressed on myeloid cells-1, contrast-induced acute kidney injury