Kinetic eGFR and Novel AKI Biomarkers to Predict Renal Recovery

摘要: Background and objectives Prompt recognition of severe renal impairment could improve the early management critically ill patients. We compared value kinetic eGFR, plasma neutrophil gelatinase–associated lipocalin (NGAL), urine tissue inhibitor metalloproteinase-2 insulin-like growth factor–binding protein 7 ([TIMP-2]*[IGFBP7]) in predicting short-term recovery from AKI major adverse kidney events. Design, setting, participants, & measurements During 6-month study period, 245 patients were admitted to our intensive care unit. This included 57 consecutive presenting with within first 24 hours after admission. markers evaluated at inclusion (day 0) later 1). Kinetic eGFR was calculated on day 1 according serum creatinine evolution. Renal defined as normalization reversal oliguria 48 hours. Major events death, need for RRT, or persistence dysfunction hospital discharge. Results Plasma NGAL [TIMP-2]*[IGFBP7] predicted recovery, area under receiver-operating characteristic curve (AUC-ROC) values between 0.70 0.79 inclusion. Although frequently reached maximal measurement range, their decrease recovery. The calculation initial resuscitation provided best AUC-ROC 0.87. predictions by (equal AUC-ROCs 0.81). Combining addition clinical prediction models improved discrimination reclassification who will recover suffer Conclusions Biomarkers damage an unselected cohort Calculating imposed a delay but good diagnostic prognostic approach. utility functional marker combinations information requires validation larger prospective studies.