Title:
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Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients
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Author:
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Cuartero, Mireia; Ballús Noguera, Josep; Sabater, J.; Perez-Fernandez, Xose L.; Nin, Nicolás; Ordoñez Llanos, Jorge; Betbesé Roig, Antoni Jordi; Universitat Autònoma de Barcelona
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Abstract:
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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. 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. 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%. 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. The online version of this article (doi:10.1186/s13613-017-0317-y) contains supplementary material, which is available to authorized users. |
Subject(s):
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-Acute kidney injury -Biomarkers -Tissue inhibitor of metalloproteinases-2 -Insulin-like growth factor-binding protein 7 -ICU patients -Sepsis |
Rights:
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open access
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https://creativecommons.org/licenses/by/4.0/ |
Document type:
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Article |
Published by:
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Uri:
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https://ddd.uab.cat/record/253978
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