Kidney Injury Molcule-1 in Acute and Chronic Kidney Disease

Kidney Injury Molecule-1 (KIM-1 in humans, Kim-1 in rodents) was first reported in 1998 as a highly up regulated protein in rat ischemic kidneys, and was subsequently demonstrated as a urinary biomarker in 2002 by our laboratory. KIM-1 expression is absent in healthy kidney epithelium, but is markedly upregulated with tubular injury or dedifferentiation providing a high signal-to-noise ratio for accurate detection of kidney injury. Since its discovery, KIM-1 has evolved as a diagnostic, prognostic and predictive biomarker of various kidney diseases. Based on results from our laboratory and other research groups including large consortia, Federal Drug Administration (FDA), European Medicines Agency (EMA), and the Japanese Pharmaceuticals and Medical Devices Agency (PMDA) have qualified KIM-1 as a marker to monitor kidney injury in preclinical studies and on a case-by-case basis in clinical trials. Recent studies also highlight the therapeutic aspects of anti-KIM-1 agents in mitigating renal injury. We also discussed a selected number of recent patents on KIM-1 pertaining to kidney pathophysiology.