The evaluation of KIM-1, profilin-1 levels and thiol disulphide homeostasis in contrastinduced nephropathy

Introduction: Contrast-induced Nephropathy (CIN) is the third most common cause of acute kidney injury which develops in hospitals. Some biomarkers may recognize kidney injury in the early stage because kidney injury immediately happens after applying contrast media procedure. Kidney Injury Molecule-1(KIM-1) is a protein that is produced at extremely low contents in the kidney under physiological conditions, Profilin-1 (PFN-1) leads to endothelium cell dysfunction and it has been associated with acute kidney injury. Plasma thiol disulphide homeostasis shows a synergistic effect with contrast agent and it has been figured out that Plasma TDH increases the frequency of incidence of acute kidney injury. The purpose of this study is to evaluate the usability of KIM-1, PFN-1 levels and TDH in assessing the risk of CIN development with the contrast agent administration. Objectives: The purpose of this study is to determine the risk of development of Contrastinduced Nephropathy by assessing KIM-1, Profilin-1 level and thiol disulfide homeostasis of patients with renal dysfunction or without, and of healthy volunteers who are given contrast agent during coronary angiography. Methods: After the approval of Ethics Committee of the study, in the angiography unit of our hospital, from the patients who were about to be applied coronary angiography between January and June 2023, the sample of blood was taken into two biochemistry tubes before the procedure. Being centrifuged, the tubes were held at -80° C'. All the patients, who had coronary angiography, were given to low osmos (500-700 mOsm/kg) İohexol (Omnipaque) (viskosite:6,3 ionisite:300) intravenously. They were asked to come control for the control within 48-72 hours after coronary angiography procedure. Their routine control blood samples were checked. In a total of 90 participants, 30 of whom coronary angiography did not develop CIN, 30 who developed CIN, and 30 healthy volunteers who were routinely examined and with no additional disease, KIM-1, PFN-1 and TDH levels were evaluated. XI Results: PFN-1 was on average 318,6±84,9 pg/ml in the control group, 631,1±431,8 pg/ml in patients developing CIN, and 414,92±183,31 in patients not developing CIN. The difference between the group of developing CIN and not developing CIN was very significant(p=0,015). KIM- 1 was on average 1,9±0,5 ng/ml in the control group, 5,8±1,1 ng/ml in patients developing CIN, and 2,7±1,0 ng/ml in patients not developing CIN. A strong positive correlation came out between PFN- 1 AND KIM-1(r=0,789 p≤0,001). The difference of KIM-1 levels in patients developing CIN and not developing was very significant (p=0,043). The difference between total thiol, natural thiol, disulfide, disulfide/natural thiol (SS/SH), disulfide/total thiol (SS/TT), natural thiol/total thiol (SH/TT) levels of the groups with and without CMN was not statistically significant. (p=0.965, p=0.933, p=983, p=0.856, p=0.891, p=0,891, respectively). The difference between the natural thiol, disulfide, disulfide/natural thiol (SS/SH), disulfide/total thiol (SS/TT), natural thiol/total thiol (SH/TT) values of the patients who developed CMN and the healthy control group was statistically significant ( p<0,001, for all). The difference between natural thiol, disulfide, disulfide/natural thiol (SS/SH), disulfide/total thiol (SS/TT), natural thiol/total thiol (SH/TT) values of the patients who did not develop CMN and the healthy control group was statistically significant ( p<0,001, for all). Conclusion: In procedures where contrast agent is applied for diagnosis and treatment, it is very important to take necessary precautions by diagnosing CIN early. Before giving contrast agent to the patients who have the risk of CIN development, the measurement of KIM-1and PFN-1 levels is a promising marker that will help take early precautions for diagnosing the risk of CIN development, shorten the length of hospital stay, and reduce morbidity and mortality. Keywords: Contrast-induced Nephropathy, KIM-1, Profilin-1, Thiol disulphide homeostasis