Abstract: Objective To explore the correlation and its diagnostic value between urine kidney injury molecule-1（KIM-1） levels and acute kidney injury （AKI） in the patients with postpartum hemorrhage. Methods Clinical data of 185 cases of postpartum hemorrhage were retrospectively analysed，according to AKI diagnostic criteria. The patients were divided into 46 cases of AKI group and 139 cases of non-AKI group. The urine occult blood and protein were detected by urine paper test，serum creatinine level was detected by alkaline picric acid method，urine KIM-1 level was determined by ELISA. The AKI risk factors was analysed by logistic regression. The diagnostic value of urine KIM-1 and other indicators for AKI were evaluated by receiver operating curve （ROC）. Results The SCr，urine KIM-1，postpartum hemorrhage volume and the rates of gestational diabetes，gestational hypertension，placental abruption，preeclampsia，positive urinary protein，positive urine occult blood in AKI group were significantly higher than those in non-AKI group （all P＜0.05）. The urine KIM-1 level was positively correlated with urine protein，urine occult blood and SCr in AKI patients （r=0.798，0.630，0.600，0.887，P＜0.05），and no correlation of other indexes were found. Logistic multivariate regression analysis showed that urine KIM-1，protein，occult blood，and SCr were risk factors for AKI （all P＜0.05）. The optimal cut-off value of urine KIM-1 as an indicator for AKI diagnosis was projected to be 5.21 ng/mL，which yielded a sensitivity of 78.4% and a specificity of 82.9% with an area under the curve （AUC） of 0.811 （95%CI：0.649～0.929，P＜0.05）. The AUC of urine KIM-1 for KAI diagnosis was higher than urine protein （AUC：0.732，95%CI：0.600～0.864，P＜0.05），urine occult blood （AUC：0.758，95%CI：0.634～0.882，P＜0.05），and SCr （AUC：0.676，95%CI：0.539～0.813，P＜0.05）. Conclusion Urinary KIM-1 is a risk factor for AKI and detection of KIM-1 may provide a reference for the diagnosis of AKI.

Key words: Kidney injury molecule-1, Postpartum hemorrhage , Acute kidney injury , Diagnosis