Predicting Acute Kidney Injury in Intensive Care Unit Patients: The Role of Tissue Inhibitor of Metalloproteinases-2 and Insulin-Like Growth Factor-Binding Protein-7 Biomarkers

Blood Purif. 2018;45(1-3):270-277. doi: 10.1159/000485591. Epub 2018 Jan 26.

Abstract

Background: Acute kidney injury (AKI) diagnosis is based on a rise in serum creatinine and/or fall in urine output. It has been shown that there are patients that fulfill AKI definition but do not have AKI, and there are also patients with evidence of renal injury who do not meet any criteria for AKI. Recently the innovative and emerging proteomic technology has enabled the identification of novel biomarkers that allow improved risk stratification.

Methods: Tissue inhibitor of metalloproteinases-2 (TIMP-2), insulin-like growth factor-binding protein 7 (IGFBP7) were measured to a cohort of 719 consecutive patients admitted to Intensive Care Unit (ICU). The primary endpoint was the evaluation of clinical performances of the biomarkers focusing on the probability do develop AKI in the first 7 days.

Results: The Kaplan-Meier analysis considering the first 7 days of ICU stay suggested a lower risk of developing AKI (p < 0.0001) for patients with a negative (<0.3; TIMP-2*IGFBP7) test.

Conclusion: (TIMP-2*IGFBP7) at ICU admission has a good performance in predicting AKI, especially in the first 4 days in ICU.

Keywords: Acute kidney injury; Cell cycle arrest biomarker; Tissue inhibitor of metalloproteinases-2 and insulin-like growth factor-binding protein 7.

Publication types

  • Clinical Trial

MeSH terms

  • Acute Kidney Injury / blood*
  • Acute Kidney Injury / mortality*
  • Aged
  • Biomarkers / blood
  • Disease-Free Survival
  • Female
  • Humans
  • Insulin-Like Growth Factor Binding Proteins / blood*
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Survival Rate
  • Tissue Inhibitor of Metalloproteinase-2 / blood*

Substances

  • Biomarkers
  • Insulin-Like Growth Factor Binding Proteins
  • TIMP2 protein, human
  • insulin-like growth factor binding protein-related protein 1
  • Tissue Inhibitor of Metalloproteinase-2