Diagnostic Value of Urine Tissue Inhibitor of Metalloproteinase-2 and Insulin-Like Growth Factor-Binding Protein 7 for Acute Kidney Injury: A Meta-Analysis

Abstract

BackgroundTissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein-7 (IGFBP7) are both involved in renal tubular epithelial cell cycle arrest in acute kidney injury (AKI). Several recent studies showed that urine TIMP-2 times IGFBP7 ([TIMP-2]*[IGFBP7]) is a promising biomarker to predict AKI.MethodsThe aim of this meta-analysis was to assess the diagnostic value of urine [TIMP-2]*[IGFBP7] for early diagnosis of AKI. Relevant studies were retrieved from the PubMed, EMBASE, and Cochrane Library databases. The sensitivity and specificity were determined, and summary receiver operating characteristic (SROC) curves were constructed.ResultsTen full-text prospective studies were included in this meta-analysis. The estimated sensitivity of urine [TIMP-2]*[IGFBP7] for the early diagnosis of AKI was 0.84 (95% CI = 0.80–0.88) and the specificity was 0.57 (95%CI = 0.55–0.60). The SROC analysis showed an area under the curve of 0.8813.LimitationThe limited number of included studies, small sample size, unpublished negative results and language limitation might have affected the evaluation.ConclusionUrine [TIMP-2]*[IGFBP7] is a promising candidate for early detection of AKI, especially in ruling-out AKI. However, the potential of this biomarker should be validated in larger studies with a broader spectrum of clinical settings.

Predictive value of cell cycle arrest biomarkers for cardiac surgery-associated acute kidney injury: a meta-analysis

“…Our results are in line with a previous meta-analysis not limited to CSA-AKI (including only 203 cardiac surgery patients). 14 2 Interestingly, studies that assessed the outcome over 24 h after operation showed improved accuracy compared with those using 12 h. This result may have occurred because the biomarkers were measured during or immediately after surgery, whereas in the discovery studies, patients were enrolled up to 24 h after ICU admission. 34,35 Twenty-four hours is a convenient time for the risk assessment after cardiac surgery, as many patients are able to be discharged from the ICU before 24 h. Thus, knowing the risk for a complication like AKI before discharge could significantly impact managementdincluding use of various drugs such as angiotensin converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) and NSAIDS.…”

“…8e12 Previous meta-analyses have evaluated the diagnostic value of [TIMP-2]$[IGFBP7] for AKI, but were underpowered to examine CSA-AKI specifically. 13,14 Recently, five new studies have evaluated the value of urinary [TIMP-2]$ [IGFBP7] in the diagnosis of CSA-AKI, and the threshold values of the biomarkers for predicting CSA-AKI remains somewhat controversial. 15e19 We included these new data and conducted this meta-analysis to assess the predictive value of urinary [TIMP-2]$[IGFBP7] as an early biomarker for CSA-AKI.…”

Prognostic value of cell cycle arrest biomarkers in patients at high risk for acute kidney injury: A systematic review and meta‐analysis

“…The predictive value of urinary [TIMP‐2]·[IGFBP7] for AKI was discussed in our previous study . Further, Su Y also identified the diagnostic value of this parameter for AKI. However, few studies have assessed the diagnostic accuracy of this parameter for RRT and mortality.…”

Acute Effect of Coffee Consumption on Urinary Proteome in Young Healthy Individuals

“…The canonical pathway analysis demonstrated that protein changes were highly associated with Hepatic fibrosis/ hepatic stellate cell activation, Glycolysis and Inhibition of matrix metalloproteases signaling ( Figure 5A). Metalloproteinase inhibitor 2 (TIMP2), involved in renal tubular epithelial cell cycle arrest in acute kidney injury, play a significant role in several pathways, 13 such as Hepatic fibrosis/ hepatic stellate cell activation, Inhibition of matrix metalloproteases signaling and glioma invasiveness signaling. 14-3-3 protein gamma (YWHAG) also involved in several canonical pathways, such as cell cycle: G2/M DNA damage checkpoint regulation, ERK5 signaling, Myc mediated apoptosis signaling and HIPPO signaling.…”