Serial Urinary Tissue Inhibitor of Metalloproteinase-2 and Insulin-Like Growth Factor-Binding Protein 7 and the Prognosis for Acute Kidney Injury over the Course of Critical Illness.

摘要: Introduction Over the course of critical illness, there is a risk acute kidney injury (AKI), and when it occurs, associated with increased length stay, morbidity, mortality. The urinary cell-cycle arrest markers tissue inhibitor metalloproteinase-2 (TIMP-2) insulin-like growth factor binding protein 7 (IGFBP7) have been utilized to predict AKI over next 12 h from time sampling. aim this analysis was evaluate utility [TIMP-2] × [IGFBP7] measured serially anticipate occurrence first days illness. Methods This prospective, blinded, observational, international study patients admitted intensive care units. We designed emulate clinician-driven serial testing strategy. Urine samples collected every up 3 530 were considered for analysis. evaluated results measurements (baseline, 24 h) continued additional if any positive >0.3 (ng/mL)2/1,000. Patients stratified by number (ng/mL)2/1,000 >2.0 primary endpoint stage 2-3 defined Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results median (interquartile range) age 64 (53-74) years, 61% men, 79% Caucasian. APACHE III score 71 (51-93), 82% required mechanical ventilation. Baseline serum creatinine 0.8 mg/dL 164/530 (31%) developed day baseline 2/3 26 (8-56) h. In negative values tests (≤0.3 (ng/mL)2/1,000), cumulative incidence at 13.0%. Conversely, those one, two, or three strongly (>2.0 57.7, 75.0, 94.4%, respectively, p Conclusion Serial baseline, h, through are prognostic Three consecutive (ng/mL)2/1,000) very low (13.0%) days. emerging persistent, [>2.0 [ng/mL]2/1,000] high rates (up 94.4%) AKI. There rate test between 0.3 2.0 (ng/mL)2/1,000, where observed in third cases.