{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:04:48Z","timestamp":1790816688617,"version":"4.1.0"},"reference-count":24,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009687","name":"Wroclaw Medical University","doi-asserted-by":"publisher","award":["SUBZ.C210.22.068"],"award-info":[{"award-number":["SUBZ.C210.22.068"]}],"id":[{"id":"10.13039\/501100009687","id-type":"DOI","asserted-by":"publisher"}]},{"award":["SUBZ.C210.22.068"],"award-info":[{"award-number":["SUBZ.C210.22.068"]}],"id":[{"id":"https:\/\/ror.org\/01qpw1b93","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Early diagnosis of chronic kidney disease (CKD) remains a major clinical challenge. Periostin (POST) and kidney injury molecule-1 (KIM-1) have been proposed as biomarkers of tubular injury and fibrosis. This study aimed to evaluate their utility as markers associated with CKD stage and their associations with renal function and proteinuria in children. Twenty-three children with CKD stages I\u2013IV and 23 healthy controls were enrolled. Serum and urinary POST and KIM-1 were measured together with creatinine (CR), cystatin C (CysC), proteinuria, albuminuria, and urinary \u03b11- and \u03b22-microglobulin. Patients were classified as early stage (ES; CKD I\u2013II) or late stage (LS; CKD III\u2013IV). Serum and urinary POST and KIM-1, uPOST\/CR, uKIM-1\/CR, fractional excretion indices (FePOST, FeKIM-1), and UPCR were higher in CKD patients than in controls. Absolute biomarker concentrations did not differ between ES and LS and were not associated with eGFR, UPCR, UACR, or tubular protein excretion. In contrast, uPOST\/CR, uKIM-1\/CR, FePOST, and FeKIM-1 increased with CKD stage, were higher in LS than ES, correlated positively with CysC, and inversely with eGFR. FePOST and FeKIM-1 also correlated strongly with tubular protein markers. The FePOST\/FeKIM-1 ratio was elevated in ES patients compared with controls and remained stable across CKD stages. Fractional excretion of POST and KIM-1 is associated with CKD stage and reflects ongoing tubular injury in children. The FePOST\/FeKIM-1 ratio may represent a sensitive marker of early CKD.<\/jats:p>","DOI":"10.3390\/ijms27083640","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:24:23Z","timestamp":1776673463000},"page":"3640","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Periostin and KIM-1 as Fibrosis-Related Markers Associated with CKD Stage in Children"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8750-7389","authenticated-orcid":false,"given":"Agnieszka","family":"Pukaj\u0142o-Marczyk","sequence":"first","affiliation":[{"name":"Clinical Department of Paediatric Nephrology, Wroclaw Medical University, ul. Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Medy\u0144ska","sequence":"additional","affiliation":[{"name":"Clinical Department of Paediatric Nephrology, Wroclaw Medical University, ul. Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Jakubowska","sequence":"additional","affiliation":[{"name":"Clinical Department of Paediatric Nephrology, Wroclaw Medical University, ul. Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Wuczy\u0144ski","sequence":"additional","affiliation":[{"name":"Statistical Analysis Centre, Wroclaw Medical University, ul. K. Marcinkowskiego 2\u20136, 50-368 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danuta","family":"Zwoli\u0144ska","sequence":"additional","affiliation":[{"name":"Clinical Department of Paediatric Nephrology, Wroclaw Medical University, ul. Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Kili\u015b-Pstrusi\u0144ska","sequence":"additional","affiliation":[{"name":"Clinical Department of Paediatric Nephrology, Wroclaw Medical University, ul. Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"494","DOI":"10.5114\/ceji.2021.110317","article-title":"The role of periostin in kidney diseases","volume":"46","author":"Turczyn","year":"2021","journal-title":"Cent. Eur. J. Immunol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Pan\u0103, N., and C\u0103pu\u0219\u0103, C. (2022). Periostin as a biomarker in the setting of glomerular diseases\u2014A review of the current literature. Biomedicines, 10.","DOI":"10.3390\/biomedicines10123211"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1159\/000485325","article-title":"Experimental inhibition of periostin attenuates kidney fibrosis","volume":"46","author":"Hwang","year":"2017","journal-title":"Am. J. Nephrol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1007\/s13258-023-01400-x","article-title":"Interference of periostin attenuates pathological changes, proinflammatory markers and renal fibrosis in diabetic kidney injury","volume":"45","author":"Duan","year":"2023","journal-title":"Genes Genom."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.transproceed.2013.07.069","article-title":"Urine periostin as a biomarker of renal injury in chronic allograft nephropathy","volume":"46","author":"Satirapoj","year":"2014","journal-title":"Transplant. Proc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1177\/0961203314566634","article-title":"Periostin: A novel tissue biomarker correlates with chronicity index and renal function in lupus nephritis patients","volume":"24","author":"Wantanasiri","year":"2015","journal-title":"Lupus"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"100","DOI":"10.5530\/ijmedph.2019.3.23","article-title":"Urinary periostin as an early predictor of renal injury in diabetic kidney disease: A tertiary centre experience","volume":"9","author":"Patel","year":"2019","journal-title":"Int. J. Med. Public Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/j.immuni.2007.11.011","article-title":"TIM-1 and TIM-4 glycoproteins bind phosphatidylserine and mediate uptake of apoptotic cells","volume":"27","author":"Kobayashi","year":"2007","journal-title":"Immunity"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1515\/cclm-2013-0157","article-title":"Establishment of reference values for novel urinary biomarkers for renal damage in the healthy population: Are age and gender an issue?","volume":"51","author":"Pennemans","year":"2013","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1046\/j.1523-1755.2002.00433.x","article-title":"Kidney injury molecule-1 (KIM-1): A novel biomarker for human renal proximal tubule injury","volume":"62","author":"Han","year":"2002","journal-title":"Kidney Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"4135","DOI":"10.1074\/jbc.273.7.4135","article-title":"Kidney injury molecule-1 (KIM-1), a putative epithelial cell adhesion molecule containing a novel immunoglobulin domain, is up-regulated in renal cells after injury","volume":"273","author":"Ichimura","year":"1998","journal-title":"J. Biol. Chem."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1172\/JCI34487","article-title":"Kidney injury molecule-1 is a phosphatidylserine receptor that confers a phagocytic phenotype on epithelial cells","volume":"118","author":"Ichimura","year":"2008","journal-title":"J. Clin. Investig."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1080\/0886022X.2016.1193816","article-title":"Kidney injury molecule-1 in kidney disease","volume":"38","author":"Yin","year":"2016","journal-title":"Ren. Fail."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3265","DOI":"10.1093\/ndt\/gfp010","article-title":"Kidney injury molecule-1 (KIM-1): A urinary biomarker and much more","volume":"24","author":"Bonventre","year":"2009","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s11010-016-2700-7","article-title":"Kidney injury molecule-1 (KIM-1) mediates renal epithelial cell repair via ERK MAPK signaling pathway","volume":"416","author":"Zhang","year":"2016","journal-title":"Mol. Cell. Biochem."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1093\/ndt\/gfw203","article-title":"Relationship of proximal tubular injury to chronic kidney disease as assessed by urinary kidney injury molecule-1 in five cohort studies","volume":"31","author":"Waikar","year":"2016","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3229","DOI":"10.1093\/ndt\/gfr023","article-title":"Urinary kidney injury molecule-1 in patients with IgA nephropathy is closely associated with disease severity","volume":"26","author":"Xu","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1681\/ASN.0000000602","article-title":"Biomarker Panels for Discriminating Risk of CKD Progression in Children","volume":"36","author":"Greenberg","year":"2025","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2702","DOI":"10.1093\/ndt\/gfr670","article-title":"Periostin: Novel tissue and urinary biomarker of progressive renal injury induces a coordinated mesenchymal phenotype in tubular cells","volume":"27","author":"Satirapoj","year":"2012","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000547867","article-title":"Plasma and urinary KIM-1 in chronic kidney disease: Prognostic value, associations with albuminuria, and implications for kidney failure and mortality","volume":"11","author":"McDonnell","year":"2025","journal-title":"Am. J. Nephrol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1053\/ajkd.2003.50040","article-title":"Fractional excretion of IgG predicts renal outcome and response to therapy in primary focal segmental glomerulosclerosis: A pilot study","volume":"41","author":"Bazzi","year":"2003","journal-title":"Am. J. Kidney Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"201","DOI":"10.5414\/CNP68201","article-title":"Fractional excretion of high- and low-molecular weight proteins and outcome in primary focal segmental glomerulosclerosis","volume":"68","author":"Deegens","year":"2007","journal-title":"Clin. Nephrol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1542\/peds.58.2.259","article-title":"A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine","volume":"58","author":"Schwartz","year":"1976","journal-title":"Pediatrics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1038\/ki.2012.169","article-title":"Improved equations estimating GFR in children with chronic kidney disease using an immunonephelometric determination of cystatin C","volume":"82","author":"Schwartz","year":"2012","journal-title":"Kidney Int."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/8\/3640\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:36:10Z","timestamp":1776674170000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/8\/3640"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,19]]},"references-count":24,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["ijms27083640"],"URL":"https:\/\/doi.org\/10.3390\/ijms27083640","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,19]]}}}