The Role of Cell Cycle Arrest Biomarkers for Predicting Acute Kidney Injury in Critically Ill COVID-19 Patients: A Multicenter, Observational Study.

Objectives: Patients with COVID-19-associated acute respiratory distress syndrome (ARDS) have a high risk for developing acute kidney injury (AKI) which is associated with an increased risk of death and persistent renal failure. Early prediction of AKI is crucial in order to implement preventive strategies. The purpose of this study was to investigate the predictive performance of tissue inhibitor of metalloproteinases 2 and insulin like growth factor binding protein 7 (TIMP-2) × (IGFBP7) in critically ill patients with COVID-19-associated ARDS.
Design: Multicenter, prospective, observational study.
Setting: Twelve centers across Europe and United Kingdom.
Patients: Patients with moderate or severe COVID-19-associated ARDS were included and serial measurements of (TIMP-2) × (IGFBP7) were performed.
Interventions: None.
Measurements and Main Results: The primary endpoint was the development of moderate or severe AKI according to the Kidney Disease: Improving Global Outcomes definition. Three hundred patients were available for the primary analysis, and 39 met the primary endpoint. At enrollment, urinary (TIMP-2) × (IGFBP7) had high predictive value for the primary endpoint with an area under the receiver operating characteristic curve of 0.89 (95% CI, 0.84-0.93). (TIMP-2) × (IGFBP7) was significantly higher in endpoint-positive patients at enrollment and at 12 hours.
Conclusions: Urinary (TIMP-2) × (IGFBP7) predicts the occurrence of AKI in critically ill patients with COVID-19-associated ARDS.
Competing Interests: Dr. Ostermann received research funding from BioMérieux and Baxter. Dr. Garcia received funding from Edwards Lifesciences. Dr. Cano disclosed work for hire. Dr. Broch-Porcar disclosed that she participated in a lecture in Nephroweek with economical compensation from BioMereiux. Drs. de la Peña, Meersch, and Zarbock received funding from Baxter. Dr. Brivio received funding from Jafron and Bbraun. Dr. de Rosa received lectures fees from ESTOR SpA. Drs. Kellum’s and Zarbock’s institutions received funding from BioMereiux. Drs. Kellum, Meersch, and Zarbock received funding from BioMereiux. Dr. Meersch received funding from FMC and Baxter. Dr. Gerss received honoraria from TESARO, QUIRIS Healthcare, Ecker+Ecker, Dr August Wolff, Roche, University Clinics Schleswig-Holstein, and RWTH Aachen University. Dr. von Groote was supported by a rotational position of KFO 342, funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)–ZA428/18-1. Dr. Zarbock’s institution received funding from DFG, Baxter, and Fresenius; he received funding from AM Pharma, Novartis, Alexion, Bayer, Guard Therapeutics, Paion, and Fresenius as well as independent research grants from the German Research Foundation. The remaining authors have disclosed that they do not have any potential conflicts of interest.
(Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.)