Urinary Vitamin D Binding Protein and Kidney Injury Molecule-1 Are Potent Predictors of Acute Kidney Injury After Left Ventricular Assist Device Implantation

Authors

Shiyi Li
Iván Murrieta-Álvarez
Katherine V Nordick
Zachary Gray
Camila Hochman-Mendez
Alexis E Shafii
Kenneth K Liao
Carl P Walther
Nandan K Mondal

Language

English

Publication Date

10-31-2025

Journal

Biomedicines

DOI

10.3390/biomedicines13112682

PMID

41301775

PMCID

PMC12650049

PubMedCentral® Posted Date

10-31-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background/Objectives: Acute kidney injury (AKI) is a frequent and serious complication following left ventricular assist device (LVAD) implantation. This study aimed to predict AKI within 90 days post-LVAD by evaluating urinary levels of vitamin D binding protein (VDBP) and kidney injury molecule-1 (KIM-1).

Methods: We prospectively enrolled 29 advanced heart failure patients undergoing LVAD implantation and categorized them into four groups based on pre-LVAD kidney function and hemodynamic stability. Early-morning urine samples were collected 24 h before and 1 week after surgery. Urinary VDBP and KIM-1 levels, normalized to creatinine, were measured.

Results: Thirteen patients developed AKI postoperatively. Both biomarkers were significantly elevated in patients with pre-existing kidney dysfunction and hemodynamic instability, as well as in those who developed AKI. Pre-LVAD VDBP and KIM-1 levels were associated with a nearly two-fold increased AKI risk. After adjusting for kidney function and hemodynamic status, this risk rose to 776% for KIM-1 and 674% for VDBP.

Conclusions: Urinary VDBP and KIM-1 are promising non-invasive biomarkers for predicting AKI in LVAD patients. The predictive performance can be greatly improved after combining with pre-LVAD kidney function and hemodynamic stability. Early measurement may help identify high-risk individuals and guide perioperative management.

Keywords

mechanical circulatory support device, acute kidney injury, Vitamin D binding protein, kidney injury molecule-1

Published Open-Access

no

Recommended Citation

Li, Shiyi; Murrieta-Álvarez, Iván; Nordick, Katherine V; et al., "Urinary Vitamin D Binding Protein and Kidney Injury Molecule-1 Are Potent Predictors of Acute Kidney Injury After Left Ventricular Assist Device Implantation" (2025). Faculty, Staff and Students Publications. 3769.
https://digitalcommons.library.tmc.edu/baylor_docs/3769