The predictive value of TIMP-2 and IGFBP7 for kidney failure and 30-day mortality after elective cardiac surgery

Esmeijer, Kevin; Schoe, Abraham; Ruhaak, L. Renee; Hoogeveen, Ellen K.; Soonawala, Darius; Romijn, Fred P.H.T.M.; Shirzada, Maryam R; Dissel, Jaap T. van; Cobbaert, Christa; Fijter, Johan W. de

doi:10.1038/s41598-020-80196-2

Cited by 21 publications

(13 citation statements)

References 31 publications

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“…Harrell's C-statistic (concordance index), the net reclassification index (NRI), and the integrated discrimination improvement (IDI) were also determined. [18][19][20] Decision curve analyses were applied to the validation cohort to compare nomogram performance with other methods of predicting fatty liver. 21 The statistical analysis were performed with R version 3.6.2 (http://www.r-project.org/).…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Nomogram for Prediction of the Risk of MAFLD in an Overweight and Obese Population

Song¹,

Ge²,

Chen³

et al. 2022

J Clin Transl Hepatol

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Background and Aims: Metabolic associated fatty liver disease (MAFLD) is a serious condition, and a simple method is needed for practitioners to identify patients with the disease and have a high risk of disease progression. Methods: We developed and validated a nomogram for fatty liver disease and reclassified the risk factors for MAFLD. The development cohort had 335 patients who received bioelectrical impedance analysis and liver ultrasound attenuation measurements at Shenzhen People's Hospital between September 2020 and June 2021. The validation cohort had 200 patients from other hospitals who received the same evaluation. A random forest procedure and binary logistic analysis were used to screen for risk factors, establish a fatty liver disease predictive model, and forecast the risk of MAFLD. The performance of the nomogram was evaluated by measurement of discrimination, calibration, and clinical usefulness. Results: The nomogram provided good predictions in a model that included body mass index (BMI) and waist circumference. The areas under the curve of the nomogram were 0.793 in the development cohort and 0.774 in the validation cohort. The nomogram performed well for calibration, category-free net reclassification improvement, and integrated discrimination improvement. Decision curve analysis indicated the nomogram performed better than BMI for predicting net outcome. Conclusions: The nomogram was an effective screening tool for fatty liver disease, and for those overweight individuals, may help physicians make appropriate decisions regarding treatment of MAFLD.

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Section: Discussionmentioning

confidence: 99%

Development and Validation of a Nomogram for Prediction of the Risk of MAFLD in an Overweight and Obese Population

Song¹,

Ge²,

Chen³

et al. 2022

J Clin Transl Hepatol

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“…Doctors and researchers have striven to find a "troponin-equivalent" marker for the precise identification of patients with AKI at an early stage, such as cystatin C, kidney injury molecule-1, or neutrophil gelatinaseassociated lipocalin [49][50][51]. What is more, the urinary biomarkers tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin growth factor-binding protein 7 (IGFBP7) have been approved to help in identifying patients at a high risk for AKI in some interventional studies in cardiac and visceral surgery settings [52][53][54], as well as for improving the prediction levels of RRT and 30-day mortality after cardiac surgery [55]. The advantage is that they are able to detect kidney stress prior to injury or loss of function, allowing for much earlier therapy as compared to management guided by serum creatinine and urine output [54].…”

Section: Discussionmentioning

confidence: 99%

“…A combination of treatments-including nutritional support [72] and glycemic control [25], minimizing nephrotoxic medication exposure [73], and hemodynamic optimization [29,34,74,75]-have largely been studied. Recently, new biomarkers of AKI have been discovered and validated [49][50][51]55]. In general, a combination of the biomarkers (urinary TIMP-2 and IGFBP7) for the early detection of perioperative kidney damage and accelerated intervention schemes seems to be the basis for AKI prophylaxis and treatment in surgical settings [52,55].…”

Section: Discussionmentioning

confidence: 99%

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Incidence and Associations of Acute Kidney Injury after General Thoracic Surgery: A System Review and Meta-Analysis

Yan

et al. 2022

JCM

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(1) Background: Acute kidney injury (AKI) is related to adverse outcomes in critical illness and cardiovascular surgery. In this study, a systematic literature review and meta-analysis was carried out to evaluate the incidence and associations of AKI as a postoperative complication of thoracic (including lung resection and esophageal) surgical procedures. (2) Methods: Adopting a systematic strategy, the electronic reference databases (PubMed, EMBASE, and Cochrane Library) were searched for articles researching postoperative renal outcomes that were diagnosed using RIFLE, AKIN or KDIGO consensus criteria in the context of a thoracic operation. A random-effects model was applied to estimate the incidence of AKI and, where reported, the pooled relative risk of mortality and non-renal complications after AKI. The meta-analysis is registered in PROSPERO under the number CRD42021274166. (3) Results: In total, 20 studies with information gathered from 34,826 patients after thoracic surgery were covered. Comprehensively, the incidence of AKI was estimated to be 8.8% (95% CI: 6.7–10.8%). A significant difference was found in the mortality of patients with and without AKI (RR = 2.93, 95% CI: 1.79–4.79, p < 0.001). Additionally, in patients experiencing AKI, cardiovascular and respiratory complications were more common (p = 0.01 and p < 0.001, respectively). (4) Conclusions: AKI is a common complication associated with adverse outcomes following general thoracic surgery. An important issue in perioperative care, AKI should be considered as a highly significant prognostic indicator and an attractive target for potential therapeutic interventions, especially in high-risk populations.

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“…A total of 76 citations resulted from the PubMed search. After reviewing the abstracts of the citations and excluding studies involving more homogeneous populations often in specialty ICUs (eg, cardiac surgery, 3 burns, 4 trauma, 5 or liver transplantation, 6 ), there were 20 retrieved articles. An EMBASE search identified 2 additional articles (appendix).…”

Section: Data Sourcesmentioning

confidence: 99%

Usefulness of the Biomarker TIMP-2•IGFBP7 for Acute Kidney Injury Assessment in Critically Ill Patients: A Narrative Review

Erstad

2021

Ann Pharmacother

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Objectives: To review the clinical usefulness of the biomarker TIMP-2•IGFBP7 in adult, general medical-surgical intensive care unit (ICU) settings. Data Sources: PubMed (1946 to mid-February 2021) and EMBASE (1947 to mid-February 2021) with bibliographies of retrieved articles reviewed for additional articles. Study Selection and Data Extraction: Studies evaluating use of the urinary TIMP-2•IGFBP7 assay in adult patients in ICU settings. Data Synthesis: Studies published after investigations leading to TIMP-2•IGFBP7 assay approval confirm the appropriateness of considerations discussed in product labeling, such as use of the test within 12 hours of assessment, use of a dichotomous 0.3 (ng/mL)2/1000 cutoff, and use only in combination with other assessments of acute kidney injury (AKI). However, as a biomarker routinely used for early identification of patients at risk for AKI in mixed ICU populations, the additional resources required for TIMP-2•IGFBP monitoring are difficult to justify because of limited data demonstrating usefulness in preventing or ameliorating AKI and its attendant complications. Relevance to Patient Care and Clinical Practice: Biomarkers are potentially useful not only for assessment and diagnosis of AKI, but also for practitioners involved in the management of nephrotoxic medications and medications needing adjustment for decreased kidney function. Conclusions: Although there is evidence to suggest that the urinary TIMP-2•IGFBP7 biomarker is helpful in predicting AKI progression in general medical-surgical ICU patients when used within 12 hours of patient assessment in combination with routine testing, including serum creatinine and urine output, there is little evidence that its use leads to improvements in clinically important patient outcomes.

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The predictive value of TIMP-2 and IGFBP7 for kidney failure and 30-day mortality after elective cardiac surgery

Cited by 21 publications

References 31 publications

Development and Validation of a Nomogram for Prediction of the Risk of MAFLD in an Overweight and Obese Population

Development and Validation of a Nomogram for Prediction of the Risk of MAFLD in an Overweight and Obese Population

Incidence and Associations of Acute Kidney Injury after General Thoracic Surgery: A System Review and Meta-Analysis

Usefulness of the Biomarker TIMP-2•IGFBP7 for Acute Kidney Injury Assessment in Critically Ill Patients: A Narrative Review

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