Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
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Kidney injury molecule-1 as a biomarker of diabetic kidney disease in children with type 1 diabetes: a systematic review and quantitative synthesis

  • Aristeidis Christakopoulos (Program of Postgraduate Studies Adolescent Medicine and Adolescent Health Care, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki) ;
  • Nikolaos Gkiourtzis (4th Department of Pediatrics, Papageorgiou General Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki) ;
  • Anastasia Stoimeni (4th Department of Pediatrics, Papageorgiou General Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki) ;
  • Assimina Galli-Tsinopoulou (Program of Postgraduate Studies Adolescent Medicine and Adolescent Health Care, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki) ;
  • Athanasios Christoforidis (1st Department of Pediatrics, Hippokration General Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki) ;
  • Despoina Tramma (4th Department of Pediatrics, Papageorgiou General Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki)
  • Received : 2025.12.05
  • Accepted : 2026.02.05
  • Published : 2026.02.28
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Abstract

Tubulointerstitial damage is a common diabetic kidney disease (DKD) complication caused by diabetes mellitus. However, many patients may not present with albuminuria or impaired glomerular filtration rate (GFR), making it difficult to detect kidney dysfunction. Kidney injury molecule-1 (KIM-1) is an emerging biomarker of early DKD, reflecting tubular injury before glomerular dysfunction. We explored the association between KIM-1 and DKD in children and adolescents with type 1 diabetes (T1D). We included 10 studies with 842 participants published between 2016 and 2025. A literature search of MEDLINE/PubMed, Cochrane Library, and Scopus was conducted from inception through January 5, 2026. The mean difference with a 95% confidence interval (CI) was calculated, and a P-value of <0.05 was considered statistically significant. A quality assessment of the included studies was conducted using the Newcastle-Ottawa Scale. In the meta-analysis of four studies, the urinary KIM-1 (uKIM-1)/creatinine ratio was elevated before changes in estimated GFR (95% CI, 0.02-0.48; P=0.03). This review suggests that uKIM-1/creatinine ratio and uKIM-1 may act as promising tubular biomarkers associated with early kidney injury in pediatric patients with T1D. However, further data are needed to clarify their role in pediatric DKD.

Keywords

References

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