Association of Kidney Injury Molecule-1 (KIM-1) levels in urine with preeclampsia

Abstract

Introduction: Preeclampsia is a major hypertensive disorder of pregnancy and a leading cause of maternal and perinatal morbidity and mortality worldwide. Kidney Injury Molecule-1 (KIM-1) has emerged as a promising biomarker of early renal tubular injury; however, its association with severe preeclampsia remains insufficiently established. Material and methods: An analytic observational study with a cross-sectional design was conducted between June and December 2024 at Hasanuddin University Hospital, Makassar, Indonesia. A total of 105 pregnant women were enrolled, including 70 women with severe preeclampsia and 35 normotensive controls. Midstream urine samples were collected and urinary Kidney Injury Molecule-1 (KIM-1) levels were measured using enzyme-linked immunosorbent assay (ELISA). Comparisons between groups were performed using the Mann–Whitney U test and Kruskal–Wallis test, while correlations were assessed using Spearman’s rank correlation. A p-value <0.05 was considered statistically significant. Results: Urinary KIM-1 levels were significantly higher in women with severe preeclampsia than in normotensive controls (median 2.03 [1.50–3.70] vs. 1.34 [0.60–1.53] ng/mL, p < 0.001). Urinary KIM-1 levels showed significant positive correlations with systolic blood pressure (r = 0.544, p < 0.001) and diastolic blood pressure (r = 0.447, p < 0.001). Higher urinary KIM-1 concentrations were also observed in overweight women (p = 0.033) and in preterm pregnancies (p = 0.020). Conclusion: Urinary KIM-1 levels were significantly elevated in women with severe preeclampsia and were positively associated with blood pressure, suggesting that urinary KIM-1 may serve as a sensitive, non-invasive biomarker of early renal tubular injury in severe preeclampsia.

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