{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:04:06Z","timestamp":1790697846750,"version":"4.1.0"},"reference-count":43,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"unspecified","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2026,7,3]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether circulating kidney injury molecule-1 (KIM-1) predicts long-term renal outcomes in lupus nephritis (LN), including relapse, progression to end-stage kidney disease (ESKD) and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 63 Japanese patients with biopsy-confirmed LN who were treated at Kanazawa University Hospital between 1990 and 2022. After excluding 17 patients who did not meet the eligibility criteria, 46 patients were included in the final analysis. Circulating KIM-1 levels were measured in serum samples collected at the time of renal biopsy prior to treatment or additional treatment. Patients were stratified into low-KIM-1 and high-KIM-1 groups using the median value (153\u2009pg\/mL) as the cut-off. The primary endpoints were LN relapse, ESKD and all-cause mortality. Survival was analysed using Kaplan-Meier curves and Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow-up of 127 months, nine patients (20%) experienced relapse, four (9%) developed ESKD and six (13%) died. The high-KIM-1 group had lower baseline renal function, greater proteinuria, a higher frequency of Class IV histology and higher activity index scores. Kaplan-Meier analysis demonstrated significantly lower LN relapse-free (p=0.027; log-rank) and ESKD-free survival (p=0.049) in the high-KIM-1 group. In the multivariable Cox regression analysis, circulating KIM-1 was independently associated with LN relapse (per-IQR HR: 1.92, 95%\u2009CI 1.07 to 3.45; p=0.029).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated circulating KIM-1 at the time of renal biopsy was associated with adverse long-term renal outcomes in LN and independently associated with relapse, although its incremental predictive value beyond conventional clinical markers was modest. KIM-1 may support early risk stratification and individualised treatment; however, prospective validation in larger cohorts is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2026-002067","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T16:30:15Z","timestamp":1784824215000},"page":"e002067","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Circulating kidney injury molecule-1 as a prognostic biomarker for long-term renal outcomes in lupus nephritis: a retrospective cohort study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8272-5085","authenticated-orcid":false,"given":"Keisuke","family":"Sako","sequence":"first","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitada","family":"Toyota","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiori","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Rheumatology Research Group, Centre for Inflammatory Diseases, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daichi","family":"Yomogida","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misaki","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akari","family":"Takeji","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Yuasa","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiko","family":"Koshino","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Tsuge","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Yamamura","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megumi","family":"Oshima","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoaki","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihiko","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miho","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph V","family":"Bonventre","sequence":"additional","affiliation":[{"name":"Division of Renal Medicine and Engineering in Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasunori","family":"Iwata","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Kanazawa University, Kanazawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"2026092908101102000_13.2.e002067.1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(24)00398-2"},{"key":"2026092908101102000_13.2.e002067.2","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1038\/s41572-025-00653-y","article-title":"Lupus nephritis","volume":"11","author":"Parodis","year":"2025","journal-title":"Nat Rev Dis Primers"},{"key":"2026092908101102000_13.2.e002067.3","article-title":"Immunosuppressive treatment for proliferative lupus nephritis","volume":"6","author":"Tunnicliffe","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"2026092908101102000_13.2.e002067.4","doi-asserted-by":"publisher","DOI":"10.7326\/M14-1030"},{"key":"2026092908101102000_13.2.e002067.5","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(21)00578-x"},{"key":"2026092908101102000_13.2.e002067.6","doi-asserted-by":"publisher","DOI":"10.1177\/0961203320932219"},{"key":"2026092908101102000_13.2.e002067.7","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05040513"},{"key":"2026092908101102000_13.2.e002067.8","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1177\/0961203316671813","article-title":"Lupus nephritis is associated with more corticosteroid-associated organ damage but less corticosteroid non-associated organ damage","volume":"26","author":"Joo","year":"2017","journal-title":"Lupus"},{"key":"2026092908101102000_13.2.e002067.9","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfw289"},{"key":"2026092908101102000_13.2.e002067.10","doi-asserted-by":"crossref","DOI":"10.1136\/lupus-2021-000533","article-title":"Absence of renal remission portends poor long-term kidney outcome in lupus nephritis","volume":"8","author":"Pirson","year":"2021","journal-title":"Lupus Sci Med"},{"key":"2026092908101102000_13.2.e002067.11","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1093\/labmed\/lmae015","article-title":"Noninvasive biomarkers for lupus nephritis","volume":"55","author":"Liu","year":"2024","journal-title":"Lab Med"},{"key":"2026092908101102000_13.2.e002067.12","doi-asserted-by":"crossref","DOI":"10.1155\/2010\/638413","article-title":"Biomarkers for lupus nephritis: a critical appraisal","volume":"2010","author":"Mok","year":"2010","journal-title":"J Biomed Biotechnol"},{"key":"2026092908101102000_13.2.e002067.13","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1002\/art.43212","article-title":"American College of Rheumatology (ACR) Guideline for the Screening, Treatment, and Management of Lupus Nephritis","volume":"77","author":"Sammaritano","year":"2024","journal-title":"Arthritis Rheumatol"},{"key":"2026092908101102000_13.2.e002067.14","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ard.2025.09.007","article-title":"EULAR recommendations for the management of systemic lupus erythematosus with kidney involvement: 2025 update","volume":"85","author":"Fanouriakis","year":"2026","journal-title":"Ann Rheum Dis"},{"key":"2026092908101102000_13.2.e002067.15","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.kint.2023.09.001","article-title":"Executive summary of the KDIGO 2024 Clinical Practice Guideline for the Management of Lupus Nephritis","volume":"105","author":"Rovin","year":"2024","journal-title":"Kidney Int"},{"key":"2026092908101102000_13.2.e002067.16","doi-asserted-by":"crossref","DOI":"10.1172\/jci.insight.172569","article-title":"Urine proteomic signatures of histological class, activity, chronicity, and treatment response in lupus nephritis","volume":"9","author":"Fava","year":"2024","journal-title":"JCI Insight"},{"key":"2026092908101102000_13.2.e002067.17","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.100007"},{"key":"2026092908101102000_13.2.e002067.18","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.273.7.4135"},{"key":"2026092908101102000_13.2.e002067.19","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.00285.2002"},{"key":"2026092908101102000_13.2.e002067.20","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2002.00433.x"},{"key":"2026092908101102000_13.2.e002067.21","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2022010098"},{"key":"2026092908101102000_13.2.e002067.22","doi-asserted-by":"publisher","DOI":"10.1177\/0961203314526292"},{"key":"2026092908101102000_13.2.e002067.23","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1177\/09612033221135871","article-title":"U-KIM-1 as a predictor of treatment response in lupus nephritis","volume":"32","author":"Nozaki","year":"2023","journal-title":"Lupus"},{"key":"2026092908101102000_13.2.e002067.24","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1177\/0961203318788167","article-title":"Composite urinary biomarkers to predict pathological tubulointerstitial lesions in lupus nephritis","volume":"27","author":"Ding","year":"2018","journal-title":"Lupus"},{"key":"2026092908101102000_13.2.e002067.25","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2010.165"},{"key":"2026092908101102000_13.2.e002067.26","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2013070758"},{"key":"2026092908101102000_13.2.e002067.27","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1053\/j.ajkd.2021.05.013","article-title":"Plasma Kidney Injury Molecule 1 in CKD: Findings From the Boston Kidney Biopsy Cohort and CRIC Studies","volume":"79","author":"Schmidt","year":"2022","journal-title":"Am J Kidney Dis"},{"key":"2026092908101102000_13.2.e002067.28","doi-asserted-by":"crossref","first-page":"2256","DOI":"10.1177\/09612033211061475","article-title":"Something new about prognostic factors for lupus nephritis? A systematic review","volume":"30","author":"Rodr\u00edguez-Almaraz","year":"2021","journal-title":"Lupus"},{"key":"2026092908101102000_13.2.e002067.29","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03280807"},{"key":"2026092908101102000_13.2.e002067.30","doi-asserted-by":"crossref","DOI":"10.1002\/art.1780400928","article-title":"Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus","volume":"40","author":"Hochberg","year":"1997","journal-title":"Arthritis Rheum"},{"key":"2026092908101102000_13.2.e002067.31","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.12.034"},{"key":"2026092908101102000_13.2.e002067.32","first-page":"288","article-title":"Systemic lupus erythematosus disease activity index 2000","volume":"29","author":"Gladman","year":"2002","journal-title":"J Rheumatol"},{"key":"2026092908101102000_13.2.e002067.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.09.002"},{"key":"2026092908101102000_13.2.e002067.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2017.11.023"},{"key":"2026092908101102000_13.2.e002067.35","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1984.75"},{"key":"2026092908101102000_13.2.e002067.36","doi-asserted-by":"publisher","DOI":"10.1177\/09612033211034234"},{"key":"2026092908101102000_13.2.e002067.37","doi-asserted-by":"crossref","DOI":"10.1016\/j.xkme.2022.100496","article-title":"Plasma Kidney Injury Molecule-1 in Systemic Lupus Erythematosus: Discordance Between ELISA and Proximity Extension Assay","volume":"4","author":"Schmidt","year":"2022","journal-title":"Kidney Med"},{"key":"2026092908101102000_13.2.e002067.38","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"2026092908101102000_13.2.e002067.39","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1002\/acr.20441","article-title":"Predicting outcomes of lupus nephritis with tubulointerstitial inflammation and scarring","volume":"63","author":"Hsieh","year":"2011","journal-title":"Arthritis Care & Research"},{"key":"2026092908101102000_13.2.e002067.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2017.07.007"},{"key":"2026092908101102000_13.2.e002067.41","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2021111453"},{"key":"2026092908101102000_13.2.e002067.42","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1002\/art.43427","article-title":"Biomarkers of Lupus Nephritis Histopathology: Where Do We Stand?","volume":"78","author":"Querin","year":"2026","journal-title":"Arthritis Rheumatol"},{"key":"2026092908101102000_13.2.e002067.43","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1053\/j.ajkd.2015.04.040","article-title":"Long-term Stability of Urinary Biomarkers of Acute Kidney Injury in Children","volume":"67","author":"Schuh","year":"2016","journal-title":"Am J Kidney Dis"}],"container-title":["Lupus Science &amp; Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/lupus-2026-002067","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:14:34Z","timestamp":1790694874000},"score":1,"resource":{"primary":{"URL":"https:\/\/lupus.bmj.com\/lookup\/doi\/10.1136\/lupus-2026-002067"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":43,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,7,23]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/lupus-2026-002067"],"URL":"https:\/\/doi.org\/10.1136\/lupus-2026-002067","relation":{},"ISSN":["2053-8790"],"issn-type":[{"value":"2053-8790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}