{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:18:46Z","timestamp":1791598726411,"version":"4.3.4"},"reference-count":27,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,16]],"date-time":"2025-03-16T00:00:00Z","timestamp":1742083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CIMB"],"abstract":"<jats:p>Background: Microscopic polyangiitis (MPA) is a type of necrotizing vasculitis that primarily affects small vessels and belongs to the spectrum of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs). While previous studies have identified potential prognostic biomarkers, further research is needed to validate a reliable marker for risk stratification in clinical practice. Kidney injury molecule-1 (Kim-1), a transmembrane protein expressed on proximal tubular epithelial cells, has been implicated in tubular damage. This study investigated the potential of Kim-1 as a biomarker in MPA. Methods: Kidney biopsy tissues, along with urine and blood samples, were retrospectively analyzed from 52 MPA patients and compared to urine samples from 7 healthy controls. Global disease activity was assessed using the Birmingham vasculitis activity score (BVAS) and vasculitis damage index, while renal disease activity was evaluated using renal BVAS (BVAS-R). Results: Urinary Kim-1 levels were significantly elevated in MPA patients compared to healthy controls. Urinary Kim-1 was positively correlated with the Mayo Clinic Chronicity Score (MCCS) but not with the ANCA Kidney Risk Score (AKRiS), whereas tubular Kim-1 was associated with AKRiS but not with MCCS, indicating their distinct pathological significance. Higher tubular Kim-1 expression was observed in patients with elevated BVAS-R. Urinary Kim-1 levels correlated with proteinuria and were associated with the Mayo Clinic Chronicity Score (MCCS) and ANCA Kidney Risk Score (AKRiS) but not with glomerular lesion severity. Unlike C-reactive protein (CRP), neither urinary nor tubular Kim-1 predicted MPA recurrence. Conclusions: Urinary Kim-1 reflects histopathologic findings and renal impairment but does not predict systemic disease activity or recurrence in MPA, demonstrating its potential clinical utility as a biomarker for assessing chronic renal damage.<\/jats:p>","DOI":"10.3390\/cimb47030196","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T04:29:28Z","timestamp":1742185768000},"page":"196","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Urinary Kim-1 Correlates with Interstitial Nephritis Activity in Patients with Microscopic Polyangiitis"],"prefix":"10.3390","volume":"47","author":[{"given":"Chisato","family":"Ashida","sequence":"first","affiliation":[{"name":"Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka 589-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2810-1519","authenticated-orcid":false,"given":"Yuji","family":"Nozaki","sequence":"additional","affiliation":[{"name":"Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka 589-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhai","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka 589-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Akazawa","sequence":"additional","affiliation":[{"name":"Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka 589-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Kishimoto","sequence":"additional","affiliation":[{"name":"Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka 589-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1809-5143","authenticated-orcid":false,"given":"Koji","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka 589-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itaru","family":"Matsumura","sequence":"additional","affiliation":[{"name":"Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka 589-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1016\/j.autrev.2016.07.016","article-title":"The clinical presentation and therapy of diseases related to anti-neutrophil cytoplasmic antibodies (ANCA)","volume":"15","author":"Weiner","year":"2016","journal-title":"Autoimmun. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41572-020-0204-y","article-title":"ANCA-associated vasculitis","volume":"6","author":"Kitching","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s11926-017-0641-0","article-title":"ANCA-Associated Vasculitis Pathogenesis: A Commentary","volume":"19","author":"Gapud","year":"2017","journal-title":"Curr. Rheumatol. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1002\/art.1780370206","article-title":"Nomenclature of Systemic Vasculitides","volume":"37","author":"Jennette","year":"1994","journal-title":"Arthritis Rheum."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1055\/s-0038-1673387","article-title":"Microscopic Polyangiitis: New Insights into Pathogenesis, Clinical Features and Therapy","volume":"39","author":"Karras","year":"2018","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1007\/s10157-015-1199-7","article-title":"Risk factors associated with relapse or infectious complications in Japanese patients with microscopic polyangiitis","volume":"20","author":"Kitagawa","year":"2015","journal-title":"Clin. Exp. Nephrol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1186\/s13075-023-03210-8","article-title":"Risk prediction model for mortality in microscopic polyangiitis: Multicentre REVEAL cohort study","volume":"25","author":"Kotani","year":"2023","journal-title":"Arthritis Res. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1038\/s41584-018-0145-y","article-title":"Pathogenesis and therapeutic interventions for ANCA-associated vasculitis","volume":"15","author":"Nakazawa","year":"2018","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1053\/j.ajkd.2019.04.031","article-title":"ANCA-Associated Vasculitis: Core Curriculum 2020","volume":"75","author":"Geetha","year":"2020","journal-title":"Am. J. Kidney Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/0272-6386(95)90098-5","article-title":"Relationship between disease activity and anti-neutrophil cytoplasmic antibody concentration in long-term management of systemic vasculitis","volume":"25","author":"Gaskin","year":"1995","journal-title":"Am. J. Kidney Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1093\/rheumatology\/kex170","article-title":"A multicentre study to improve clinical interpretation of proteinase-3 and myeloperoxidase anti-neutrophil cytoplasmic antibodies","volume":"56","author":"Bossuyt","year":"2017","journal-title":"Rheumatology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1053\/j.ajkd.2021.03.027","article-title":"ANCA-Negative Pauci-immune Necrotizing Glomerulonephritis: A Case Series and a New Clinical Classification","volume":"79","author":"Ronsin","year":"2022","journal-title":"Am. J. Kidney Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"64","DOI":"10.17691\/stm2021.13.3.08","article-title":"Kidney Injury Molecule 1 (KIM-1): A Multifunctional Glycoprotein and Biological Marker","volume":"13","author":"Karmakova","year":"2021","journal-title":"Sovrem. Teh. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1177\/0961203314526292","article-title":"Estimation of kidney injury molecule-1 (Kim-1) in patients with lupus nephritis","volume":"23","author":"Nozaki","year":"2014","journal-title":"Lupus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"674","DOI":"10.3899\/jrheum.120879","article-title":"Urinary Biomarkers in Relapsing Antineutrophil Cytoplasmic Antibody-associated Vasculitis","volume":"40","author":"Lieberthal","year":"2013","journal-title":"J. Rheumatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1136\/annrheumdis-2021-221796","article-title":"2022 American College of Rheumatology\/European Alliance of Associations for Rheumatology classification criteria for microscopic polyangiitis","volume":"81","author":"Suppiah","year":"2022","journal-title":"Ann. Rheum. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/j.kint.2017.01.002","article-title":"A proposal for standardized grading of chronic changes in native kidney biopsy specimens","volume":"91","author":"Sethi","year":"2017","journal-title":"Kidney Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/j.kint.2018.07.020","article-title":"Development and validation of a renal risk score in ANCA-associated glomerulonephritis","volume":"94","author":"Brix","year":"2018","journal-title":"Kidney Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1681\/ASN.2010050477","article-title":"Histopathologic Classification of ANCA-Associated Glomerulonephritis","volume":"21","author":"Berden","year":"2010","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1080\/25785826.2024.2366313","article-title":"Comparative analysis of renal decline rates in microscopic polyangiitis: Unveiling the slowly progressive phenotype","volume":"47","author":"Tsutsumi","year":"2024","journal-title":"Immunol. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1159\/000492407","article-title":"Prognostic Value of Urinary Calprotectin, NGAL and KIM-1 in Chronic Kidney Disease","volume":"43","author":"Seibert","year":"2018","journal-title":"Kidney Blood Press. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1007\/s11255-019-02311-1","article-title":"Kidney injury molecule-1, a sensitive and specific marker for identifying acute proximal tubular injury, can be used to predict renal functional recovery in native renal biopsies","volume":"51","author":"Yin","year":"2019","journal-title":"Int. Urol. Nephrol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.arcmed.2017.10.005","article-title":"Kidney Injury Molecule-1 Level is Associated with the Severity of Renal Interstitial Injury and Prognosis in Adult Henoch\u2013Sch\u00f6nlein Purpura Nephritis","volume":"48","author":"Zhang","year":"2017","journal-title":"Arch. Med. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"48","DOI":"10.17116\/terarkh201789648-55","article-title":"Kidney injury molecules (KIM-1, MCP-1) and type IV collagen in the assessment of activity of antineutrophil cytoplasmic antibody-associated glomerulonephritis","volume":"89","author":"Bulanov","year":"2017","journal-title":"Ter. Arkhiv"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1111\/cei.12422","article-title":"Are urinary levels of high mobility group box 1 markers of active nephritis in anti-neutrophil cytoplasmic antibody-associated vasculitis?","volume":"178","author":"Abdulahad","year":"2014","journal-title":"Clin. Exp. Immunol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Sandino-Berm\u00fadez, M.J., Hern\u00e1ndez-Andrade, A., Hinojosa-Azaola, A., Mart\u00edn-Nares, E., and Mej\u00eda-Vilet, J.M. (2024). Performance of clinical and histological prognostic scores for kidney survival in ANCA-associated vasculitis. Rheumatology, keae336.","DOI":"10.1093\/rheumatology\/keae336"},{"key":"ref_27","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"}],"container-title":["Current Issues in Molecular Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1467-3045\/47\/3\/196\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:54:38Z","timestamp":1760028878000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1467-3045\/47\/3\/196"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,16]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["cimb47030196"],"URL":"https:\/\/doi.org\/10.3390\/cimb47030196","relation":{},"ISSN":["1467-3045"],"issn-type":[{"value":"1467-3045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,16]]}}}