The KIM-1, IL-18 and NGAL are biomarkers for kidney injury. They rise up within 6-12 h after kidney injury. My question is: are these biomarkers could be detected in serum without kidney injury? if so what is the threshold between the normal and abnormal levels?
Dear Abdeslalam,
i suppose it depends on the analytical precision of your detection equipment. For example, if you use ELISA kits vs. HPLC-MS/MS, you might not get the same detection and quantification limit.
Regards,
Dear Paul
Thank you for your answer. Yes, there is difference between them.
Indeed, I analyzed serum biomarkers by ELISA, these biomarkers were detected even in control group where there is no evident of kidney injury. In the literatures I didn't get any informations (about the threshold) between normal and abnormal levels.
Maybe the following papers will help you:
Yasar Kandur1, Sevim Gonen, Kibriya Fidan1, Oguz Soylemezoglu. Evaluation of urinary KIM-1, NGAL, and IL-18 levels in determining early renal injury in pediatric cases with hypercalciuria and/or renal calculi. Clinical Nephrology, Volume 86 (2016) - August (62 - 69)
Dear Abdeelsalam
As Paul mentioned it depend on accuracy of the analytical platform used. I would like to elaborate further.
For a example, you get more accurate results on monoplex than multiplex ELISA (Luminex). Therefore normal range for a given sample will be different if you use two different analytical platforms.
KIM1 and NGAL are candidate biomarkers mostly validated in hospital acquired AKI. Still it needs validation on different population (age, sex, ethnicity) and various diseases (eg; community acquired AKI).
Furthermore, the biomarker ranges will change as per disease severity.
The reference range of NGAL and KIM1 for general use on individual patients clinical decision (like serum creatinine) will be available after proper validation and standardization of these markers.
Current research compare patients' (cases) biomarker levels with some known control groups values. Then reference values are not required. .
Dear Zeid
Thank you for this interesting comment. I searche in the literatures and I found that KIM-1 is not expressed or secreted by normal kidney tissues but it secreted only in case of AKI while NGAL and IL-18 could be detected in the serum as well as in the urine.
Great question - most of the work on IL-18 and KIM-1 was in urine. In the work that we did we noted that IL-18 was often "unmeasureable" (see eg Article Improved performance of urinary biomarkers of acute kidney i...
). However, the choice of a threshold is arbitrary because they are continuous variables. What I think you need to look for in the literature is what the sensitivity and specificity of any thresholds used are. If you want to rule-out AKI then you will want a threshold with very high sensitivity. If you want to "rule-in" (or at least classify patients to be at high-risk of AKI) then you'll want a threshold with high specificity. So, it may be better to work with two thresholds rather than one.- Badges
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