Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients
Cuartero, Mireia (Institut d'Investigació Biomèdica Sant Pau)
Ballús Noguera, Josep (Hospital Universitari de Bellvitge)
Sabater, J. (Hospital Universitari de Bellvitge)
Perez-Fernandez, Xose L. (Hospital Universitari de Bellvitge)
Nin, Nicolás (Hospital Universitario de Getafe (Madrid))
Ordoñez Llanos, Jorge 1952- (Institut d'Investigació Biomèdica Sant Pau)
Betbesé Roig, Antoni Jordi (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Data:	2017
Resum:	To analyse the usefulness of the composite index of the tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) as urinary biomarkers for the early prediction of AKI in septic and non-septic patients. This is a prospective, observational study including patients admitted to ICU from acute care departments and hospital length of stay <48 h. The main exclusion criteria were pre-existing eGFR <30 mL/min/1. 73 m 2 and hospitalisation 2 months prior to current admission. The [TIMP-2]·[IGFBP7] index was analysed twice, within the first 12 h of ICU admission. The sample included 98 patients. AKI incidence during ICU stay was 50%. Sepsis was diagnosed in 40. 8%. Baseline renal variables were comparable between subgroups except for a higher baseline eGFR in non-septic patients. Patients were stratified based on the presence of AKI and their highest level of [TIMP-2]·[IGFBP7] within the first 12 h of stay. [TIMP-2]·[IGFBP7] index values were dependent on the incidence of AKI but not of sepsis. [TIMP-2]·[IGFBP7] values were significantly related to AKI severity according to AKIN criteria (p < 0. 0001). The AUROC curve to predict AKI of the worst [TIMP-2]·[IGFBP7] index value was 0. 798 (sensitivity 73. 5%, specificity 71. 4%, p < 0. 0001). Index values below 0. 8 ruled out any need for renal replacement (NPV 100%), whereas an index >0. 8 predicted a rate of AKI of 71% and AKIN ≥ 2 of 62. 9%. In our study, urinary [TIMP-2]·[IGFBP7] was an early predictor of AKI in ICU patients regardless of sepsis. Besides, index values <0. 8(ng/mL) 2 /1000 ruled out the need for renal replacement. The online version of this article (doi:10. 1186/s13613-017-0317-y) contains supplementary material, which is available to authorized users.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Acute kidney injury ; Biomarkers ; Tissue inhibitor of metalloproteinases-2 ; Insulin-like growth factor-binding protein 7 ; ICU patients ; Sepsis
Publicat a:	Annals of Intensive Care, Vol. 7 (september 2017) , ISSN 2110-5820

DOI: 10.1186/s13613-017-0317-y
PMID: 28884304

10 p, 1.1 MB

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