Gocze, Ivan and Koch, Matthias and Renner, Philipp and Zeman, Florian and Graf, Bernhard M. and Dahlke, Marc H. and Nerlich, Michael and Schlitt, Hans J. and Kellum, John A. and Bein, Thomas (2015) Urinary Biomarkers TIMP-2 and IGFBP7 Early Predict Acute Kidney Injury after Major Surgery. PLOS ONE, 10 (3): e0120863. ISSN 1932-6203,
Full text not available from this repository. (Request a copy)Abstract
Objective To assess the ability of the urinary biomarkers IGFBP7 (insulin-like growth factor-binding protein 7) and TIMP-2 (tissue inhibitor of metalloproteinase 2) to early predict acute kidney injury (AKI) in high-risk surgical patients. Introduction Postoperative AKI is associated with an increase in short and long-term mortality. Using IGFBP7 and TIMP-2 for early detection of cellular kidney injury, thus allowing the early initiation of renal protection measures, may represent a new concept of evaluating renal function. Methods In this prospective study, urinary [TIMP-2]x[IGFBP7] was measured in surgical patients at high risk for AKI. A predefined cut-off value of [TIMP-2]x[IGFBP7] > 0.3 was used for assessing diagnostic accuracy. Perioperative characteristics were evaluated, and ROC analyses as well as logistic regression models of risk assessment were calculated with and without a [TIMP-2] x[IGFBP7] test. Results 107 patients were included in the study, of whom 45 (42%) developed AKI. The highest median values of biomarker were detected in septic, transplant and patients after hepatic surgery (1.24 vs 0.45 vs 0.47 ng/l(2)/1000). The area under receiving operating characteristic curve (AUC) for the risk of any AKI was 0.85, for early use of RRT 0.83 and for 28-day mortality 0.77. In a multivariable model with established perioperative risk factors, the [TIMP-2]x[IGFBP7] test was the strongest predictor of AKI and significantly improved the risk assessment (p<0.001). Conclusions Urinary [TIMP-2]x[IGFBP7] test sufficiently detect patients with risk of AKI after major noncardiac surgery. Due to its rapid responsiveness it extends the time frame for intervention to prevent development of AKI.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MORTALITY; AKI; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Unfallchirurgie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Jul 2019 12:55 |
| Last Modified: | 23 Jul 2019 12:55 |
| URI: | https://pred.uni-regensburg.de/id/eprint/5770 |
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