Use of TIMP-2 and IGFBP-7 for prediction of postoperative acute kidney injury after cardiac surgery

医学 急性肾损伤 体外循环 生物标志物 泌尿系统 心脏外科 前瞻性队列研究 单中心 内科学 泌尿科 外科 生物化学 化学
作者
Pey‐Jen Yu,Gabriela Rodrı́guez,Hugh A. Cassiere,Karl Bocchieri,Jamie S. Hirsch,Tylis Y. Chang,Kenar D. Jhaveri,Roland Hentz,Steven Fishbane,Purva Sharma,David Delijani,Alan R. Hartman
出处
期刊:Clinical Nephrology [Dustri-Verlag]
卷期号:98 (6): 288-295
标识
DOI:10.5414/cn110973
摘要

The following cell cycle arrest urinary biomarkers, tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP-7), have been used for early detection of acute kidney injury (AKI) in critically ill patients. The purpose of this study is to validate the use of these urinary biomarkers in patients undergoing open heart surgery.In a single-center prospective observational study, urine samples were collected in 108 consecutive patients who underwent open heart surgery immediately after separation from cardiopulmonary bypass and on postoperative day 1, and were sent for the biomarker [TIMP-2]*[IGFBP7] analysis. Acute kidney injury was defined based on KDIGO criteria, and levels of [TIMP-2]*[IGFBP7] were analyzed for the ability to predict AKI.Of the 108 patients, 19 (17.6%) patients developed postoperative AKI within 48 hours of surgery. At the threshold of > 0.3 (ng/mL)2/1,000, post-cardiopulmonary bypass [TIMP-2]*[IGFBP-7] had a sensitivity of 13% and specificity of 82% for predicting postoperative AKI. Postoperative day-1 [TIMP-2]*[IGFBP-7] had a sensitivity of 47% and a specificity of 59% for predicting postoperative AKI. There were no differences in [TIMP-2]*[IGFBP-7] values at either timepoint between patients who developed postoperative AKI as compared to those who did not.Urinary [TIMP-2]*[IGFBP7] was not predictive of the risk of AKI after cardiac surgery in this single-center study population.
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