肾损伤分子1（KIM-1）是一种跨膜糖蛋白，由近曲小管细胞表达，被视为肾损伤的早期、敏感和特异性尿液生物标志物。近期发现血液中的KIM-1与急性和慢性肾损伤的严重程度有关，但其在抗中性粒细胞胞浆抗体（ANCA）相关的肾小球肾炎（ANCA-GN）中的价值尚未研究。因此，我们分析了KIM-1在ANCA-GN诊断时的表达及其与临床表现、肾组织病理学和早期结果的关系。我们评估了KIM-1水平及其他促炎分子（C-反应蛋白、白细胞介素-6、肿瘤坏死因子α、单核细胞趋化蛋白-1和凝血素3）在ANCA-GN诊断时和6个月后的患者中，这些患者包括法国四个肾脏病学中心自2000年1月以来诊断的患者。我们评估了54名患者的血液KIM-1水平。诊断时KIM-1水平升高，经诱导缓解治疗后水平下降。KIM-1与诊断时肾损伤的严重程度以及需要肾脏替代治疗之间相关。与其他促炎分子相反，KIM-1与肾活检中的急性肾小管坏死以及间质纤维化/小管萎缩（IF/TA）相关，而与间质浸润或肾小球受累无关。在多变量分析中，升高的KIM-1可预测最初的估测肾小球滤过率（β = -19，95% CI -31，-7.6，P = .002）。KIM-1看似是ANCA-GN急性肾损伤和小管间质损伤的潜在生物标志物。KIM-1是仅仅作为替代标志物还是ANCA-GN发病机制中的关键免疫参与者，尚待确定。© 作者2023年发表。由牛津大学出版社代表ERA。

Kidney injury molecule 1 (KIM-1) is a transmembrane glycoprotein expressed by proximal tubular cells, recognized as an early, sensitive and specific urinary biomarker for kidney injury. Blood KIM-1 was recently associated with the severity of acute and chronic kidney damage but its value in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis with glomerulonephritis (ANCA-GN) has not been studied. Thus, we analyzed its expression at ANCA-GN diagnosis and its relationship with clinical presentation, kidney histopathology and early outcomes.We assessed KIM-1 levels and other pro-inflammatory molecules (C-reactive protein, interleukin-6, tumor necrosis factor α, monocyte chemoattractant protein-1 and pentraxin 3) at ANCA-GN diagnosis and after 6 months in patients included in the Maine-Anjou registry, which gathers data patients from four French Nephrology Centers diagnosed since January 2000.Blood KIM-1 levels were assessed in 54 patients. Levels were elevated at diagnosis and decreased after induction remission therapy. KIM-1 was associated with the severity of renal injury at diagnosis and the need for kidney replacement therapy. In opposition to other pro-inflammatory molecules, KIM-1 correlated with the amount of acute tubular necrosis and interstitial fibrosis/tubular atrophy (IF/TA) on kidney biopsy, but not with interstitial infiltrate or with glomerular involvement. In multivariable analysis, elevated KIM-1 predicted initial estimated glomerular filtration rate (β = -19, 95% CI -31, -7.6, P = .002).KIM-1 appears as a potential biomarker for acute kidney injury and for tubulointerstitial injury in ANCA-GN. Whether KIM-1 is only a surrogate marker or is a key immune player in ANCA-GN pathogenesis remain to be determined.© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.