Cal, M. (Massimo) de

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    Routine Adoption of Urinary [IGFBP7]∙[TIMP-2] to Assess Acute Kidney Injury at Any Stage 12 hours After Intensive Care Unit Admission: a Prospective Cohort Study
    (Springer Science and Business Media LLC, 2019) Molano-Triviño, A. (Alejandra); Carta, M.R. (María Rosa); Ronco, C. (Claudio); Senzolo, M. (Mara); Serrano-Soto, M. (Mara); Giavarina, D. (Davide); Scarpa, M. (Marta); Ferrari, F. (Fiorenza); Muraro, E. (Eva); Xie, Y. (Yun); Romero-González, G. (Gregorio); Bonato, R. (Raffaele); Puci, M.V. (Mariangela Valentina); Coutinho-Castro, A. (Ana); Corradi, V. (Valentina); Rizo-Topete, L. (Lilia); Brendolan, A. (Alessandra); Cal, M. (Massimo) de; Lorenzin, A. (Anna); Yang, B. (Bo); Husain-Syed, F. (Faeq); Ferraro, O.E. (Ottavia Eleonora)
    The urinary tissue inhibitor of metalloproteinases-2 and insulin-like growth factor-binding protein 7 ([TIMP-2]∙[IGFBP7]) have been introduced to improve risk prediction of severe acute kidney injury (AKI) within 12 hours of measurement. We performed a prospective cohort study to evaluate if the predictive value of [TIMP-2]∙[IGFBP7] for AKI might continue after 12 hours. We enrolled 442 critically ill adult patients from June to December 2016. Urine samples were collected at admission for [TIMP-2]∙[IGFBP7] measurement. Baseline patient characteristics were recorded including patients' demographics, prior health history, and the main reason for admission to build a logistic regression model to predict AKI. AKI occurrence differed between patients with [TIMP-2]∙[IGFBP7] ≤0.3 and >0.3 (ng/ml)2/1000 (31.9% and 68.10% respectively; p < 0.001). Patients with AKI had higher biomarker values compared to those without AKI (0.66 (0.21-2.84) vs 0.22 (0.08-0.63) (ng/ml)2/1000; p < 0.001). [TIMP-2]∙[IGFBP7] at ICU admission had a lower performance in predicting AKI at any stage within 48 hours and 7 days after measurement (area under the receiver operating characteristic curve (AUC) equal to 0.70 (95%CI 0.65-0.76), AUC 0.68 (95%CI 0.63-0.73)). In the logistic regression model, 0.1 (ng/ml)2/1000-unit increment was likely to increase the risk of AKI by 2% (p = 0.002).