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Tissue inhibitor metalloproteinase-2 (TIMP-2) • IGF-binding protein-7 (IGFBP7) levels are associated with adverse outcomes in patients in the intensive care unit with acute kidney injury
- Source :
- Università degli Studi di Padova-IRIS
-
Abstract
- The G1 cell cycle inhibitors tissue inhibitor metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been identified as novel biomarkers for the prediction of moderate to severe acute kidney injury (AKI) risk. However, the prognostic value of [TIMP-2]•[IGFBP7] in predicting adverse outcomes in intensive care unit (ICU) patients with AKI was not previously described. To evaluate this, we conducted a cohort study, measuring [TIMP2]•[IGFBP7] levels in critically ill patients admitted to the ICU and classified the patients as NephroCheck (NC) (+) or NC (-) according to [TIMP-2]•[IGFBP7] values and AKI (+) or AKI (-) according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We then evaluated the incidence of continuous renal replacement therapy initiation, all-cause mortality and a composite endpoint of both in the four groups. Baseline [TIMP-2]•[IGFBP7] values were available for 719 patients, of whom 239 developed AKI and 151 met the composite endpoint. Compared to NC (-)/AKI (+) patients, NC (+)/AKI (+) patients had a significant risk of ICU mortality and the composite endpoint. Kaplan-Meier curves showed that the survival estimate for the composite endpoint of NC (+)/AKI (+) patients was 34.4%; significantly worse than NC (-)/AKI (+) patients (67.4%). Multivariate analyses showed strong association between NC positivity and the composite endpoint. The inflammatory marker, procalcitonin, was an additional prognostic biomarker to compare and confirm the incremental value of NephroCheck. No association between procalcitonin and the composite endpoint was found, especially in patients with AKI, suggesting that NephroCheck may be more kidney specific. Thus, the [TIMP-2]•[IGFBP7] values can serve to identify patients with AKI at increased risk for adverse outcomes in the ICU.
- Subjects :
- 0301 basic medicine
Male
medicine.medical_treatment
030232 urology & nephrology
Kaplan-Meier Estimate
urologic and male genital diseases
outcomes
Gastroenterology
intensive care unit
Severity of Illness Index
Procalcitonin
law.invention
0302 clinical medicine
law
Hospital Mortality
Prospective Studies
Aged, 80 and over
Kidney
Incidence (epidemiology)
Acute kidney injury
Acute Kidney Injury
Middle Aged
Prognosis
Intensive care unit
female genital diseases and pregnancy complications
Insulin-Like Growth Factor Binding Proteins
Renal Replacement Therapy
Intensive Care Units
medicine.anatomical_structure
Italy
Nephrology
Female
Cohort study
medicine.medical_specialty
Risk Assessment
03 medical and health sciences
TIMP-2
Predictive Value of Tests
Internal medicine
medicine
Humans
Renal replacement therapy
Aged
Tissue Inhibitor of Metalloproteinase-2
business.industry
medicine.disease
030104 developmental biology
ROC Curve
IGFBP7
Feasibility Studies
acute kidney injury
business
Biomarkers
Kidney disease
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Università degli Studi di Padova-IRIS
- Accession number :
- edsair.doi.dedup.....e3c1623b5b0fe54067c39b56b20ce5f9