The effectiveness of urinary TIMP-2 and IGFBP-7 in predicting acute kidney injury in critically ill neonates

Chen, Jiao; Sun, Yunqing; Wang, Sanfeng; Dai, Xiangfeng; Huang, Hui; Bai, Zhidong; Li, Xiaozhong; Wang, Jian; Li, Yanhong

doi:10.1038/s41390-019-0698-8

Cited by 27 publications

(25 citation statements)

References 38 publications

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“…Increased IGFBP-7 urinary concentrations were noticed in children and neonates from intensive care units. They predicted renal outcome and distinguished between patients with and without AKI, or between those with early recovery from AKI and late or non-recovery [ 20 , 21 ].…”

Section: Markers Of Injurymentioning

confidence: 99%

“…It proved its superiority over damage markers, like urinary NGAL, KIM-1, or L-FABP, in AKI prediction among critically ill patients. The assessment of [IGFBP-7] × [TIMP-2] product gave even better results in the prediction of progression to mild/severe AKI and of 30-day and 3-month mortality due to AKI [ 20 , 21 , 22 ]. Moreover, similarly to NGAL, [IGFBP-7] × [TIMP-2] is now available in the form of a point-of-care test, Nephrocheck.…”

Section: Markers Of Injurymentioning

confidence: 99%

See 1 more Smart Citation

Current Concepts of Pediatric Acute Kidney Injury—Are We Ready to Translate Them into Everyday Practice?

Musiał

2021

JCM

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Pediatric acute kidney injury (AKI) is a major cause of morbidity and mortality in children undergoing interventional procedures. The review summarizes current classifications of AKI and acute kidney disease (AKD), as well as systematizes the knowledge on pathophysiology of kidney injury, with a special focus on renal functional reserve and tubuloglomerular feedback. The aim of this review is also to show the state-of-the-art in methods assessing risk and prognosis by discussing the potential role of risk stratification strategies, taking into account both glomerular function and clinical settings conditioned by fluid overload, urine output, or drug nephrotoxicity. The last task is to suggest careful assessment of eGFR as a surrogate marker of renal functional reserve and implementation of point-of-care testing, available in the case of biomarkers like NGAL and [IGFBP-7] × [TIMP-2] product, into everyday practice in patients at risk of AKI due to planned invasive procedures or treatment.

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Section: Markers Of Injurymentioning

confidence: 99%

Section: Markers Of Injurymentioning

confidence: 99%

Current Concepts of Pediatric Acute Kidney Injury—Are We Ready to Translate Them into Everyday Practice?

Musiał

2021

JCM

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“…The uCr level from the aliquoted sample was measured automatically on an automatic biochemical analyzer (Hitachi 7600, Tokyo, Japan) by using the sarcosine oxidase method. For urinary [TIMP-2]•[IGFBP7], the concentrations of TIMP-2 and IGFBP-7 in the urine were multiplied and then divided by 1000 to convert them into international general units, (ng/mL) 2 /1000, in accordance with our previous study [15] and study by others [16].…”

Section: Measurement Of Urinary Biomarkersmentioning

confidence: 99%

Derivation and Validation of Urinary TIMP-1 for Prediction of Acute Kidney Injury and Mortality in Critically Ill Children

Huang¹,

Lin²,

Dai³

et al. 2021

Preprint

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Background: Acute kidney injury (AKI) is associated with high morbidity and mortality. Multiple urinary biomarkers have been identified to associate with the prediction of AKI and outcomes. However, the accuracy of these urinary biomarkers for AKI and associated outcomes has not been clearly defined, especially in heterogeneous populations. The aims of the study were to compare the ability of 10 existing or potential urinary biomarkers for prediction of AKI and pediatric intensive care unit (PICU) mortality, and identify and validate the best biomarker of urinary tissue inhibitor of metalloproteinases-1 (uTIMP-1) for early prediction in heterogeneous critically ill children.Methods: A derivation-validation approach with separate critically ill cohorts was designed. We first conducted a prospective cohort study to determine the ability of 10 candidate urinary biomarkers serially measured in 123 children during the first 7 days of PICU stay and identify the best biomarker for predicting AKI and PICU mortality (derivation study). The best biomarker of uTIMP-1 from derivation was validated in a separate cohort of 357 critically ill children (validation study). AKI diagnosis was based on KDIGO classification with serum creatinine and urine output.Results: In the derivation cohort, 17 of 123 (13.8%) children developed AKI stage 3 or died during PICU stay, and both the initial and peak uTIMP-1 displayed the highest AUC of 0.87 (0.79-0.94) and 0.90 (0.84-0.96), respectively, for predicting AKI stage 3 or death. In the validation cohort, 47 of 357 (13.2%) developed AKI during the first week after admission, and 38 (10.6%) died during PICU stay. The initial uTIMP-1 level was validated to be independently associated with AKI (AOR=1.88, P=0.001), severe AKI (AOR=2.35, P<0.001), AKI stage 3 (AOR=2.87, P<0.001) and PICU mortality (AOR=1.92, P=0.019) after adjustment for potential confounders. The predictive values of uTIMP-1 for AKI, severe AKI, AKI stage 3 and PICU mortality were 0.82 (0.75-0.88), 0.84 (95%CI 0.77-0.91), 0.87 (0.81-0.94) and 0.83 (0.76-0.89), respectively.Conclusions: Urinary TIMP-1 level has been identified and validated to be independently associated with AKI and PICU mortality in independent prospective cohorts, and may be an early potential indicator of AKI and PICU mortality in critically ill children.

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“…Chen et al prospectively studied 237 neonates in the ICU, with urine samples collected correctly to measure IGFBP7 and TIMP-2, and concluded that they have a discriminative value for severe AKI in critically ill neonates. 28 However, although recent evidence from clinical studies involving BM has shown that they are promising in preventing early diagnosis and AKI management, there are still undefined points to be clarified. There is a need for further studies to identify BMs that can be appropriately selected and identify high-risk patients and different AKI phenotypes.…”

Section: Early Diagnosismentioning

confidence: 99%

Acute Kidney Injury in Children

Bresolin¹

2021

SOJPCN

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Recent literature data has shown that acute kidney injury (AKI) is a common occurrence in critically ill children and that it is associated with high rates of morbidity and mortality, even after adjusting for other risk factors. In addition, it can result in long-term sequelae translated by the development of arterial hypertension, microalbuminuria and chronic renal dysfunction. High degree of suspicion, early diagnosis based on the recognition of patients at risk and the use of new criteria for the diagnosis and classification of AKI and, whenever possible, using the new biomarkers can positively alter the prognosis of these patients. Although there is still no specific treatment for AKI, it is recommended to focus on the immediate institution of preventive measures in order to maintain renal hemodynamics, early treatment of septic patients, elimination of exogenous nephrotoxins, recognition and management of patients with AKI secondary to high levels of endotoxins, control and normalization of volume after the initial phase of fluid resuscitation, sufficient nutritional support, and recognition and treatment of the underlying causes are necessary. Patients that fail with conservative care will need renal replacement therapy.

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The effectiveness of urinary TIMP-2 and IGFBP-7 in predicting acute kidney injury in critically ill neonates

Cited by 27 publications

References 38 publications

Current Concepts of Pediatric Acute Kidney Injury—Are We Ready to Translate Them into Everyday Practice?

Current Concepts of Pediatric Acute Kidney Injury—Are We Ready to Translate Them into Everyday Practice?

Derivation and Validation of Urinary TIMP-1 for Prediction of Acute Kidney Injury and Mortality in Critically Ill Children

Acute Kidney Injury in Children

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