Assessment of Kidney Injury Molecule-1 in Acute Kidney Injury in the Neonatal Intensive Care Unit: A Study in Northeast Iran from 2019 to 2020

Document Type : Original Article


1 Department of Pathology, School of Medicine, 5th Azar Hospital, Sayyad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran

2 Neonatal and Children Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran

3 Department of Nephrology, Clinical Research Development Unit, Sayyad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran


Background: Drugs cause approximately 20%-40% of acute kidney injuries (AKI). Amikacin (AMK) is one of the common medications used as empiric therapy for severe infections, such as sepsis in neonates. One of the newly recommended biomarkers in AKI is Kidney Injury Molecule-1 (KIM-1). In this study, we evaluated the use of KIM-1 for diagnosing tubular injury in neonates treated with Amikacin in the neonatal intensive care unit (NICU) of our educational hospital in Gorgan, Iran.
Methods: This cross-sectional descriptive study was conducted at the NICU of the two educational hospitals affiliated to the Golestan University of Medical Sciences, Gorgan, Iran. There were two groups of patients, namely neonates treated with Amikacin plus Ampicillin (group A; n=45) and neonates treated with Ampicillin plus Cefotaxime (group B; n=45). Demographic characteristics were recorded. Blood and urine samples were collected in both groups. The urinary secretion of KIM-1 was determined using an ELISA kit.
Results: The total number of patients in both groups was 45, 26 (57.8%) of whom were male, and 19 (42.2%) cases were female. The mean age was obtained at 5.25±1.47 days in group A and 5.15±1.5 days in group B. None of our patients had AKI. There was no difference between leukocyte count and platelets on the first and seventh day. There was a significant difference among K, Na, urine specific gravity, C-reactive protein, Cr, and BUN on the seventh day, compared to the first day. The difference between urinary levels of KIM-1 in the two groups was not statistically significant.
Conclusion: We have not found a significant relationship between urinary KIM-1 and AKI in our patients.


  1. Moresco RN, Bochi GV, Stein CS, De Carvalho JA, Cembranel BM, Bollick YS. Urinary kidney injury molecule-1 in renal disease. Clin Chim Acta. 2018;487:15-21.
  2. Morales-Alvarez MC. Nephrotoxicity of antimi-crobials and antibiotics. Adv Chronic Kidney Dis. 2020;27(1):31-7.
  3. Downes KJ, Hayes M, Fitzgerald JC, Pais GM, Liu J, Zane NR, et al. Mechanisms of antimicrobial-induced nephrotoxicity in children. J Antimicrob Chemother. 2020;75(1):1-13.
  4. Song J, Yu J, Prayogo GW, Cao W, Wu Y, Jia Z, et al. Understanding kidney injury molecule 1: a novel immune factor in kidney pathophysiology. Am J Transl Res. 2019;11(3):1219-1229.
  5. Lin CY, Chen YC. Acute kidney injury classification: AKIN and RIFLE criteria in critical patients. World J Crit Care Med. 2012;1(2):40-5.
  6. Sridharan K, Al Jufairi M, Al Segai O, Al Ansari E, Ahmed HH, Shaban GH, et al. Biomarkers in neonates receiving potential nephrotoxic drugs. Eur Rev Med Pharmacol Sci. 2021;25(22):7078-88.
  7. Correa LP, Marzano AC, Filha RS, Magalhães RC, Simoes-e-Silva AC. Biomarkers of renal function in preterm neonates at 72 h and 3 weeks of life. J Pediatr. 2021;97(5):508-13.
  8. Alaee E, Sirati M, Taziki MH, Fouladinejad M. Risk factors for sensorineural hearing loss among high-risk infants in Golestan Province, Iran in 2010-2011. Iran Red Crescent Med J. 2015;17(12):e20419.
  9. Salahshoori Niaei F, Farah Taj Navab A. Effects of Valeriana officinalis and Ciprofloxacin on Kidney Histopathology in Rats Pyelonephritis by Pseudomonas aeruginosa. Res Biotechnol Environ Sci. 2022;1(1): 23-7.
  10. Alinejad S, Yousefichaijan P, Rezagholizamenjany M, Rafie Y, Kahbazi M, Arjmand A. Nephrotoxic effect of gentamicin and amikacin in neonates with infection. Nephro-Urol Mon. 2018;10(2):e58580.
  11. Eslami G, Salehifar E, Behbudi M, Rezai MS. Rational use of amikacin in Buali-Sina Hospital in Sari 2011. J Mazandaran Univ Med Sci. 2013;23(100):2-9.