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10.1186/s13613-017-0317-y

http://scihub22266oqcxt.onion/10.1186/s13613-017-0317-y
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suck abstract from ncbi


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pmid28884304      Ann+Intensive+Care 2017 ; 7 (ä): ä
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  • Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients #MMPMID28884304
  • Cuartero M; Ballús J; Sabater J; Pérez X; Nin N; Ordonez-Llanos J; Betbesé AJ
  • Ann Intensive Care 2017[]; 7 (ä): ä PMID28884304show ga
  • Purpose: 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. Methods: 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 m2 and hospitalisation 2 months prior to current admission. The [TIMP-2]·[IGFBP7] index was analysed twice, within the first 12 h of ICU admission. Results: 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%. Conclusions: 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. Electronic supplementary material: The online version of this article (doi:10.1186/s13613-017-0317-y) contains supplementary material, which is available to authorized users.
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