Abstract
BACKGROUND: Chronic kidney disease (CKD) is a deadly progressive disorder, particularly when it progresses to end-stage renal disease (ESRD). Conventional diagnostic tools such as serum creatinine and estimated glomerular filtration rate (eGFR) often lack sensitivity for early detection of tubular injury. This study aimed to evaluate the diagnostic potential of Galectin-3 (Gal-3) and Kidney Injury Molecule-1 (KIM-1) in Iraqi patients with CKD. METHODS: This case-control study included 150 participants from Baghdad, Iraq, between August 2022 and May 2023. Participants were categorized into three groups: healthy controls (n=50), mild CKD (n=50), and severe CKD (n=50). Serum levels of Gal-3 and KIM-1 were measured using ELISA kits. Demographic, clinical, and biochemical data were collected, including age, sex, BMI, diabetes status, hypertension, and eGFR. Statistical analyses included ANOVA, Kruskal-Wallis test, and correlation analysis. RESULTS: Gal-3 levels were significantly higher in CKD patients compared to healthy controls, showing a progressive increase from mild to severe CKD stages (P < 0.001). It was also associated with systemic factors such as diabetes mellitus, hypertension, and obesity. In contrast, KIM-1 levels were elevated primarily in patients with advanced CKD or ESRD (P = 0.036), but no significant difference was observed between control and mild CKD groups (P = 0.149). KIM-1 did not show consistent correlations with traditional markers of renal function, suggesting its specificity for structural tubular damage rather than functional decline. CONCLUSIONS: Our findings suggest that Gal-3 may serve as a broader biomarker reflecting both systemic inflammation and fibrosis, while KIM-1 appears to be more specific to advanced renal injury.