Kidney Injury Molecule-1 (KIM-1), Neutrophil Gelatinase-Associated Lipocalin (NGAL), and CRP: a potential biomarker for early prediction of Acute Kidney Injury (AKI) in pediatric male patients

Background
Acute Kidney Injury (AKI) is a serious condition that affects adolescents and children. If left untreated, it may progress rapidly and lead to chronic renal disease, which would require dialysis, and has been associated with higher morbidity and mortality after adjustment for other risk factors.

Objectives
The present study aims to predict KIM-1, NGAL, CRP, and other kidney function biomarkers in AKI pediatric patients.

Material and methods
120 pediatric males were used in the present study divided into 90 patients with AKI with a mean age of (5.94 ± 4.93) years. All patients were divided according to RIFEL for three stages: stage (32 patients), stage 2 (27 patients), and stage 3 (31 patients), as well as a control group (30 patients) with a mean of age of 7.70 ± 5.02 years. The data was collected for this research at the Kidney Unit in the Kerbala Teaching Hospital, Kerbala, Iraq. Results. The study found KIM-1 significantly (p ≤ 0.001) increased in all stages of AKI patients’ stage 1 (1,501.64 ± 417.02), stage 2 (1,638.91 ± 354.85), and stage 3 (1,474.16 ± 425.63), compared to the control group (716.64 ± 50.72). Moreover, a highly significant increase (p ≤ 0.001) in NGAL in all stages of AKI patients’ stage 1 (5.51 ± 1.23), stage 2 (5.84 ± 1.08), stage 3 (5.75 ± 1.36), and the control group (2.30 ± 0.28) was seen. There was also a highly significant increase (p ≤ 0.001) in CRP in all stages of AKI patients’ stage 1 (33.93 ± 64.75), stage 2 (35.81 ± 29.75), stage 3 (54.29 ± 64.41), and the control group (2.60 ± 0.84).

Conclusions
The increase in serum KIM-1 and serum NGAL in AKI patients is related to early prediction of renal complications, and CRP can be regarded as the main indicator of systemic inflammation markers. Therefore, KIM-1, NGAL, and CRP can be considered a biomarker for AKI.