Jiao Chen1, Yunqing Sun2, Sanfeng Wang2, Xiaomei Dai2, Hui Huang2, Zhenjiang Bai1, Xiaozhong Li2, Jian Wang3, Yanhong Li4,5. 1. Department of Pediatric Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, JiangSu province, China. 2. Department of Nephrology and Immunology, Children's Hospital of Soochow University, Suzhou, JiangSu province, China. 3. Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, JiangSu province, China. 4. Department of Nephrology and Immunology, Children's Hospital of Soochow University, Suzhou, JiangSu province, China. lyh072006@hotmail.com. 5. Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, JiangSu province, China. lyh072006@hotmail.com.
Abstract
BACKGROUD: Urinary tissue inhibitor of metalloproteinase-2 (TIMP-2), insulin-like growth factor binding protein-7 (IGFBP-7) and the combination of TIMP-2 and IGFBP-7 ([TIMP-2]•[IGFBP7]) are proposed to be predictive biomarkers for acute kidney injury (AKI). The intention of our study was to determine whether there is any significant predictive value of these biomarkers for the occurrence of AKI and severe AKI in critically ill neonates. METHODS: Urinary samples were serially collected in 237 neonates during neonatal intensive care unit (NICU) stay for measurements of TIMP-2 and IGFBP-7 in this prospective study. AKI diagnosis was based on KDIGO classification without urine output or serum creatinine >1.2 mg/dL. RESULTS: Twenty neonates developed AKI, including 11 with KDIGO stage 1, defined as mild AKI, and 9 with stages 2 and 3, defined as severe AKI. Urinary IGFBP-7 and [TIMP-2]•[IGFBP7] remained associated with AKI after adjustment for gestational age, gender and illness severity. Urinary [TIMP-2]•[IGFBP7] achieved an AUC of 0.71 (P = 0.034) and displayed a sensitivity of 88.9% and a specificity of 50.9% for discriminating severe AKI at the optimal cut-off value of 0.045. CONCLUSION: The combination of TIMP-2 and IGFBP-7 had independent discriminative value for severe AKI in critically ill neonates.
BACKGROUD: Urinary tissue inhibitor of metalloproteinase-2 (TIMP-2), insulin-like growth factor binding protein-7 (IGFBP-7) and the combination of TIMP-2 and IGFBP-7 ([TIMP-2]•[IGFBP7]) are proposed to be predictive biomarkers for acute kidney injury (AKI). The intention of our study was to determine whether there is any significant predictive value of these biomarkers for the occurrence of AKI and severe AKI in critically ill neonates. METHODS: Urinary samples were serially collected in 237 neonates during neonatal intensive care unit (NICU) stay for measurements of TIMP-2 and IGFBP-7 in this prospective study. AKI diagnosis was based on KDIGO classification without urine output or serum creatinine >1.2 mg/dL. RESULTS: Twenty neonates developed AKI, including 11 with KDIGO stage 1, defined as mild AKI, and 9 with stages 2 and 3, defined as severe AKI. Urinary IGFBP-7 and [TIMP-2]•[IGFBP7] remained associated with AKI after adjustment for gestational age, gender and illness severity. Urinary [TIMP-2]•[IGFBP7] achieved an AUC of 0.71 (P = 0.034) and displayed a sensitivity of 88.9% and a specificity of 50.9% for discriminating severe AKI at the optimal cut-off value of 0.045. CONCLUSION: The combination of TIMP-2 and IGFBP-7 had independent discriminative value for severe AKI in critically ill neonates.
Authors: Joycilene da Silva Barbosa; Geraldo Bezerra da Silva Júnior; Gdayllon Cavalcante Meneses; Alice Maria Costa Martins; Elizabeth De Francesco Daher; Rosângela Pinheiro Gonçalves Machado; Romélia Pinheiro Gonçalves Lemes Journal: J Bras Nefrol Date: 2022 Jan-Mar