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Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Am+J+Kidney+Dis 2016 ; 68 (1): 19-28 Nephropedia Template TP
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Clinical Use of the Urine Biomarker TIMP-2 × IGFBP7 for Acute Kidney Injury Risk Assessment #MMPMID26948834
Vijayan A; Faubel S; Askenazi DJ; Cerda J; Fissell WH; Heung M; Humphreys BD; Koyner JL; Liu KD; Mour G; Nolin TD; Bihorac A
Am J Kidney Dis 2016[Jul]; 68 (1): 19-28 PMID26948834show ga
Acute kidney injury (AKI) is a devastating complication commonly occurring in the critically ill population with devastating short- and long-term consequences. Despite standardization of the definition and staging of AKI, early recognition remains challenging given that serum creatinine (Scr) is a marker?albeit imperfect?of kidney function and not kidney injury. Furthermore, the delay in rise of Scr after loss of glomerular filtration also prevents timely detection of decreased kidney function in patients with AKI. Over the past decade, numerous clinical investigations have evaluated the utility of several biomarkers in the early diagnosis and risk stratification of AKI. In 2014, the US Food and Drug Administration (FDA) approved the marketing of a test based on the combination of the urine concentrations of tissue inhibitor of metalloproteinase 2 and insulin-like growth factor binding protein 7 ([TIMP-2]x[IGFBP7]) to determine if certain critically ill patients are at risk of developing moderate to severe AKI. The optimal role of this biomarker in diagnosis, management, and prognosis of AKI in different clinical settings requires further clarification. In this perspective, we summarize the biological actions of these two cell-cycle arrest biomarkers, and present important considerations regarding the clinical application, interpretation, and limitations of this novel test for the early detection AKI.