Urinary Kidney Injury Molecule 1 and Urinary Monocyte Chemotactic Protein 1 as Novelbiomarkers for Early Detection of Sickle Cell Nephropathy

Abstract

Abstract Background Sickle cell disease (SCD) is one of the most common genetic disorders, it not onlyhas hematological pathophysiological consequences, but also has systemic pathologicalmanifestations such as Sickle cell nephopathy(SN). There are no randomized control trials thatexamined the utility of screening test for renal disease in individuals with SCD. Aim of the Work To evaluate urinary monocyte chemoattractant protein-1 (MCP-1) and urinarykidney injury molecule 1 (KIM-1) as biomarkers for early detection of sickle cell nephropathy and correlate them with proteinuria and decline in estimate glomerular filtration rate ( eGFR). Patient and Methods This study was a cross sectional study, conducted at Pediatrics Hematology-Oncology Unit at Ain Shams University Children’s Hospital, where 45 children with sickle cell disease were enrolled aged 6 months - 16 years. Urine samples were collected to measure MCP-1and KIM-1 levels and compared to age and sex matched control. Results There was a statistically significant difference found between control group and patients’group regarding the level of MCP-1 in urine as it was found higher in patients than control group with median(IQR) values of 600 pg/ml (300–780) vs. 47.5 pg/ml (30–80, p < 0.001). Regarding the level of KIIM-1 in urine, it was found higher in patients than control group with median (IQR)values of 2.8 ng/ml (1.6–5.6) vs. 0.4 ng/ml (0.4–0.55, p<0.001) respectively. Conclusion Our data shows a distinct biomarker pattern in children with SCD, identifying KIM-1and MCP-1 as two potential biomarkers of early SN and its progression.