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Early diagnosis of lead poisoning is critical for timely discontinuation of lead exposure and for prognosis. This study explored the value of urinary kidney injury molecule-1 (KIM-1) in diagnosing renal injury induced by lead at an early stage. We retrospectively analyzed 92 workers exposed to occupational lead and demonstrated a better correlation ship between blood lead levels and urine excretion of KIM-1 than other traditional renal injury biomarkers following creatinine adjustment. Receiver operating characteristic curve analysis of the ability of diverse biomarkers for predicting kidney injury in lead-exposed workers demonstrated that the order of predicting accuracy of the studied biomarkers is as follows: urinary KIM-1-to-creatinine ratio\u2009&gt;\u2009urinary N-acetyl-<jats:italic>\u03b2<\/jats:italic>-(D)-glucosaminidase-to-creatinine ratio\u2009&gt;\u2009urinary <jats:italic>\u03b2<\/jats:italic>2-microglobulin-to-creatinine ratio\u2009&gt;\u2009urinary <jats:italic>\u03b1<\/jats:italic>1-microglobulin-to-creatinine ratio, with the Youden index being 16.59 ng\/g, 14.01\u2009U\/g, 0.15\u2009mg\/g, and 4.63\u2009mg\/g, respectively. Collectively, our findings suggest that short-period occupational lead exposure may cause injury of renal tubules. Urinary excretion of KIM-1 correlates with blood lead levels better than other traditional renal injury biomarkers, including N-acetyl-<jats:italic>\u03b2<\/jats:italic>-(D)-glucosaminidase, <jats:italic>\u03b1<\/jats:italic>1-microglobulin, and <jats:italic>\u03b2<\/jats:italic>2-microglobulin. Longitudinal surveillance of urinary KIM-1 may aid for early diagnosis of renal tubular injury in workers with occupational lead exposure.<\/jats:p>","DOI":"10.1038\/srep38930","type":"journal-article","created":{"date-parts":[[2016,12,14]],"date-time":"2016-12-14T10:38:34Z","timestamp":1481711914000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Urinary KIM-1: a novel biomarker for evaluation of occupational exposure to lead"],"prefix":"10.1038","volume":"6","author":[{"given":"Rong","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahong","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefang","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingya","family":"Kuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2016,12,14]]},"reference":[{"key":"BFsrep38930_CR1","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s40557-015-0085-9","volume":"27","author":"HC Kim","year":"2015","unstructured":"Kim, H. 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