Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients
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, observ...
| Autores: | ; ; ; ; ; ; |
|---|---|
| Tipo de documento: | Artículo |
| Estado: | Published version |
| Fecha de publicación: | 2017 |
| País: | España |
| Institución: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/124267 |
| Acceso en línea: | https://hdl.handle.net/2445/124267 |
| Nivel de acceso: | Acceso abierto |
| Palabra clave: | Marcadors bioquímics Insuficiència renal aguda Biochemical markers Acute renal failure |
| _version_ | 1878742826910482432 |
|---|---|
| author | Cuartero, Mireia |
| author2 | Ballús, Josep Sabater, J. Pérez, X. Nin, N. Ordoñez Llanos, Jordi Betbesé Roig, Antoni Jordi |
| author2_role | author author author author author author |
| author_browse | Ballús, Josep Betbesé Roig, Antoni Jordi Cuartero, Mireia Nin, N. Ordoñez Llanos, Jordi Pérez, X. Sabater, J. |
| author_facet | Cuartero, Mireia Ballús, Josep Sabater, J. Pérez, X. Nin, N. Ordoñez Llanos, Jordi Betbesé Roig, Antoni Jordi |
| author_role | author |
| collection | Dipòsit Digital de la UB |
| description | 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 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. 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. [TIMP2] .[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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_fcf4daa1f7f95eb5098ad4e5f17dafa8 |
| institution | Universidad de Barcelona |
| instname_str | Universidad de Barcelona |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:diposit.ub.edu:2445/124267 |
| publishDate | 2017 |
| publishDateSort | 2017 |
| publisher | Springer Heidelberg |
| publisherStr | Springer Heidelberg |
| reponame_str | Dipòsit Digital de la UB |
| spelling | Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients Cuartero, Mireia Ballús, Josep Sabater, J. Pérez, X. Nin, N. Ordoñez Llanos, Jordi Betbesé Roig, Antoni Jordi Marcadors bioquímics Insuficiència renal aguda Biochemical markers Acute renal failure 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 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. 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. [TIMP2] .[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. Springer Heidelberg https://hdl.handle.net/2445/124267 |
| spellingShingle | Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients Cuartero, Mireia Marcadors bioquímics Insuficiència renal aguda Biochemical markers Acute renal failure |
| status_str | publishedVersion |
| title | Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients |
| title_full | Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients |
| title_fullStr | Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients |
| title_full_unstemmed | Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients |
| title_short | Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients |
| title_sort | Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients |
| topic | Marcadors bioquímics Insuficiència renal aguda Biochemical markers Acute renal failure |
| topic_facet | Marcadors bioquímics Insuficiència renal aguda Biochemical markers Acute renal failure |
| url | https://hdl.handle.net/2445/124267 |