Value of Combined Detection of Urinary KIM-1,UMOD and mAlb in Assessing Rapid Decline in Renal Function of Patients with Early Diabetic Kidney Damage

BAI Weina; LI Kun; MA Li

doi:10.3969/j.issn.1002-3429.2025.11.006

Abstract：Objective To explore the value of combined detection of urinary kidney injury molecule-1(KIM-1),urinary modulin(UMOD),and microalbumin(mAlb)in assessing the rapid decline in renal function of patients with early diabetic kidney damage.Methods A total of 160 patients with early diabetic kidney damage from July 2021 to July 2023 were selected as the research subjects and followed up for one year.They were categorized into an observation group and a control group based on whether their renal function declined rapidly.The general information of the two groups and the levels of urinary KIM-1,UMOD,and mAlb on the day of admission were compared.Multivariate Logistic regression equations were used to screen the influencing factors of rapid decline in renal function of patients.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of each indicator for rapid decline in renal function.The impact of each indicator on the rapid decline in renal function was assessed using risk assessment.Results On the day of admission,the observation group had higher levels of glycosylated hemoglobin,blood urea,serum creatinine,urinary KIM-1,and mAlb than the control group,while the expression level of UMOD was lower(P<0.01).After adjusting for relevant factors,multivariate logistic regression analysis showed that urinary KIM-1,mAlb,and UMOD remained influencing factors for rapid decline in renal function(P<0.05).The area under the curve of KIM-1+UMOD+mAlb for predicting rapid decline in renal function was 0.939,which was superior to the predictive value of each indicator alone and in combination.The risk of rapid decline in renal function for patients with high values of KIM-1,mAlb,and low values of UMOD was 5.000 times,7.690 times,and 3.667 times higher,respectively,than those in patients with low values of KIM-1,mAlb,and high values of UMOD.Conclusion Urinary KIM-1,UMOD,and mAlb are all independent factors influencing the rapid decline in renal function ofn patients with early diabetic kidney damage.Combined detection has good predictive value for the rapid decline in renal function of patients,can be used as a potential predictor of the rapid decline in renal function of patients,and can guide clinical decision-making.