Urinary TIMP-2 and IGFBP7 for the prediction of acute kidney injury following cardiac surgery

BMC Nephrology

Research Article

Chunsheng Wang¹  Zhe Luo²  Yamin Zhuang²  Lan Liu²  Yimei Wang³  Jiarui Xu³  Jifu Jin³  Bo Shen³  Zhouping Zou³  Xiaoqiang Ding³  Wuhua Jiang³  Jie Teng³ 

[1] Department of Cardiovascular Surgery, Zhongshan Hospital, Shanghai Medical College, Fudan University, No 180 Fenglin Rd, Shanghai, China;Department of critical care medicine, Fudan University, No 180 Fenglin Rd, Shanghai, China;Departments of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, No 180 Fenglin Rd, Shanghai, China;

关键词: Acute kidney injury;    TIMP-2;    IGFBP7;    Cardiac surgery;    Biomarker;   

DOI  :  10.1186/s12882-017-0592-8

 received in 2017-02-27, accepted in 2017-05-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAcute kidney injury (AKI) following cardiac surgery is common and associated with poor patient outcomes. Early risk assessment for development of AKI remains a challenge. The combination of urinary tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) has been shown to be an excellent predictor of AKI following cardiac surgery, but reported studies are for predominately non-Asian populations.MethodsAdult patients were prospectively enrolled at Zhongshan hospital in Shanghai, China. The primary analysis was prediction of AKI and stage 2–3 AKI by [TIMP-2]*[IGFBP7] measured 4 h after postoperative ICU admission assessed using receiver operating characteristic curve (ROC) analysis. Kinetics of [TIMP-2]*[IGFBP7] following ICU admission were also examined.ResultsWe prospectively enrolled 57 cardiac surgery patients, of which 20 (35%) developed AKI and 6 (11%) developed stage 2–3 AKI. The area under the ROC curve (AUC) of [TIMP-2]*[IGFBP7] at 4 h after ICU admission was 0.80 (95% confidence interval (CI): 0.68–0.91) for development of AKI and 0.83 (95% CI: 0.69–0.96) for development of stage 2–3 AKI. Urinary [TIMP-2]*[IGFBP7] values at 4 h after ICU admission were significantly (P < 0.001) higher in patients who developed AKI than in patients who did not develop AKI (mean (standard error) of 1.08 (0.34) (ng/mL)2/1000 and 0.29 (0.05) (ng/mL)2/1000, respectively). The time-profile of [TIMP-2]*[IGFBP7] suggests the markers started to elevate by the time of ICU admission in patients who developed AKI and either decreased or remained flat in patients without AKI.ConclusionThe combination of urinary TIMP-2 and IGFBP7 4 h after postoperative ICU admission identifies patients at risk for developing AKI, not just stage 2–3 AKI following cardiac surgery.

【 授权许可】

CC BY   
© The Author(s). 2017