To investigate the application value of urinary kidney injury molecule-1(Kim-1) in the early diagnosis of acute obstructive suppurative cholangitis (AOSC) complicated by acute kidney injury (AKI).

Clinical data of 66 AOSC patients in Department of Hepatobiliary Surgery, Central People′s Hospital of Zhanjiang, Guangdong Province from January 2006 to January 2012 were analyzed retrospectively. The informed consents of all patients were obtained and the ethical committee approval was received. According to whether AKI occurred within 48 h after admission, the patients were divided into AKI group and non-AKI group. There were 21 patients in AKI group with 9 males and 12 females and mean age of (51±10) years old, and 45 patients in non-AKI group with 18 males and 27 females and mean age of (49±9) years old. The levels of urinary Kim-1 and serum creatinine (Scr) at the time of admission (0 h) and 12, 24,48 h after admission were recorded and compared between two groups. The value of urinary Kim-1 in the diagnosis of AKI was analyzed. The levels of urinary Kim-1 and Scr in two groups were compared using t test. The sensitivity and specificity of urinary Kim-1 in the diagnosis of AKI were analyzed using receiver operating characteristic (ROC) curve and area under curve (A).

The levels of urinary Kim-1 and Scr of patients in AKI group and non-AKI group at the time of admission (0 h) were (2.02±0.23)μg/L, (77±17)μmol/L and (1.89±0.78)μg/L, (72±16)μmol/L respectively. There was no significant difference between two groups (t=1.513, 1.742; P>0.05). The level of urinary Kim-1 of patients in AKI group began to rise at 12 h after admission and peaked at 24 h after admission, while it rose and peaked at 12 h after admission in non-AKI group. The levels of urinary Kim-1 of patients in AKI group at 12, 24, 48 h after admission were evidently higher than that in non-AKI group (t=2.975, 5.002, 7.614; P<0.05). The level of Scr of patients in AKI group was evidently higher than that in non-AKI group only at 48 h after admission(t=3.557, P<0.05). The A value of urinary Kim-1 in the diagnosis of AOSC complicated by AKI at 12 h after admission was 0.875 with the 95% confidence interval of 0.746-0.932. The best operating point on the ROC curve was defined using Youden index and the positive reference value was 2.80 μg/L, the sensitivity was 0.90, the specificity was 0.73.

Urinary Kim-1 can be a parameter in the early diagnosis of AOSC complicated by AKI.