Collectively our findings indicate that acute myocardial ischemia and reperfusion injury increase expression of inflammatory cytokines and MMP-9 levels in both the myocardium and renal cortex and further are associated with increased urinary KIM-1 levels and activation of fibrotic signaling pathways in the renal cortex (Fig. 6). This evidence concerns the gene MMP9 and myocardial ischemia.