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Annals of Clinical & Laboratory Science 38:210-214 (2008)
© 2008 Association of Clinical Scientists

Kidney Injury Molecule-1 Expression Identifies Proximal Tubular Injury in Urate Nephropathy

Manish Nepal1, Glenn H. Bock2, Azra M. Sehic2, Michael F. Schultz3 and Ping L. Zhang4
1 Departments of Internal Medicine, 2 Pediatric Nephrology, and 3 Adult Nephrology, Geisinger Medical Center, Danville, Pennsylvania, and 4 Department of Anatomic Pathology, William Beaumont Hospital, Royal Oak, Michigan

Address correspondence to Ping L. Zhang, M.D., Ph.D., Department of Anatomic Pathology, William Beaumont Hospital, 3601 West 13 Mile Road, Royal Oak, MI 48073-6769, USA; tel 248 898 9060; fax 248 898 8020; e-mail ping.zhang{at}beaumont.edu.

Urate nephropathy in children is uncommon, occurring mostly in those who have undergone chemotherapy or radiotherapy. The characteristic obstruction of distal nephron tubules by uric acid precipitates is considered key to the subsequent parenchymal injury. Whether proximal tubular injury plays a role in urate nephropathy remains unclear. We report one case of acute urate nephropathy and one case of chronic urate nephropathy in two pediatric patients. In their renal biopsies, we demonstrate upregulation of kidney injury molecule-1 (KIM-1), a specific injury marker, in proximal tubular cells. This finding implicates a role for proximal tubular injury in urate nephropathy.

Keywords: urate nephropathy, kidney injury molecule-1 (KIM-1), hyperuricemia, acute renal failure






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