Tissue Inhibitor Metalloproteinase-2 (TIMP-2)⋅IGF-Binding Protein-7 (IGFBP7) Levels Are Associated with Adverse Long-Term Outcomes in Patients with AKI

Abstract

Tissue inhibitor metalloproteinase-2 (TIMP-2) and IGF-binding protein-7 (IGFBP7) have been validated for risk stratification in AKI. However, the association of urinary TIMP-2 and IGFBP7 with longterm outcomes is unknown. We evaluated the 9-month incidence of a composite end point of all-cause mortality or the need for RRT in a secondary analysis of a prospective observational international study of critically ill adults. Two predefined [TIMP-2]z[IGFBP7] cutoffs (0.3 for high sensitivity and 2.0 for high specificity) for the development of AKI were evaluated. Cox proportional hazards models were used to determine risk for the composite end point. Baseline

The biomarkers for acute kidney injury: A clear road ahead?

“…[13] The measurement of urinary angiotensinogen could play a role in identifying patients with AKI who are likely to develop CKD, and could potentially benefit from the renin-angiotensin system (RAS) blockade. [14,15] Biomarkers may also be able to guide the decision making for the initiation of renal replacement therapy (RRT) in patients with AKI. Selected studies demonstrated that NGAL, cystatin-C, NAG, KIM-1, and a1-microglobulin had the potential to distinguish patients in whom RRT will be needed.…”

Insulin-like growth factor binding protein 7 and tissue inhibitor of metalloproteinases-2: differential expression and secretion in human kidney tubule cells

“…Additionally, these biomarkers have shown to be sensitive, specific, and highly predictive early biomarkers for AKI in adults after surgeries (21,36), and in children after cardiac surgery (37). In addition to predicting AKI, these biomarkers have been associated with long-term outcomes after AKI (28), predicting renal recovery (18), and prediction of dialysis or recovery after kidney transplantation (19). Last, remote ischemic preconditioning increased TIMP-2 and IGFBP7 preoperatively, reduced these biomarker levels in the postoperative period, and ultimately reduced the occurrence of AKI after cardiac surgery in high-risk patients, supporting the hypothesis that IGFBP7 and TIMP-2 may serve as "alarm" signals that may be protective in some conditions (74).…”

Pediatric acute kidney injury: Appraisal of predictors and prognostic indicators

“…Only few narrative review articles were included in the present review, and some were included through cross referencing. [17], urine TIMP-2 and IGFBP-7 have also been proved to be a predictor of renal recovery after AKI [18], as well as unfavorable long-term outcomes in patients with the acute disease [19]. A recent review showed that these urine biomarkers have equally been validated for the detection of AKI well ahead of clinical features like azotemia and oliguria [20].…”