• Resuscitation · Aug 2019

    Multicenter Study

    The urine biomarkers TIMP2 and IGFBP7 can identify patients who will experience severe acute kidney injury following a cardiac arrest: A prospective multicentre study.

    • Dimitri Titeca-Beauport, Delphine Daubin, Jonathan Chelly, Yoann Zerbib, Clement Brault, Momar Diouf, Michel Slama, Christophe Vinsonneau, Kada Klouche, and Julien Maizel.
    • Medical Intensive Care Unit and BoReal Study group, Amiens University Hospital, Amiens, France. Electronic address: titeca.dimitri@chu-amiens.fr.
    • Resuscitation. 2019 Aug 1; 141: 104-110.

    AimTo determine whether the urine biomarkers tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) can identify patients who will develop severe acute kidney injury (AKI) soon after cardiac arrest.MethodsWe performed a prospective, multicentre study in three French ICUs. The performance of [TIMP-2]*[IGFBP7] was assessed for urine samples collected a median [IQR] of 240 [169-315] minutes post-collapse. The primary end-point was severe AKI (KDIGO stage 3), within 48 h of admission.ResultsOf the 115 patients analyzed, 32 (28%) developed severe AKI. Eleven of these required renal replacement therapy. The median [IQR] baseline [TIMP-2]*[IGFBP7] level was higher in patients who developed severe AKI (1.57 [0.80-6.62] (ng/ml)2/1000) than in those who did not (0.17 [0.05-0.59] (ng/ml)2/1000; p < 0.001). The baseline [TIMP2]*[IGFBP7] predicted -severe AKI with an area under the curve [95% confidence interval (CI)] of 0.91 [0.84-0.95], an optimal cut-off value of 0.39 (ng/ml)2/1000, a sensitivity [95%CI] of 97% [84-100], and a specificity of 72% [61-82]. A cut-off of 2.0 (ng/ml)2/1000 yielded a specificity of 98% [92-100]. For predicting severe AKI, baseline [TIMP-2]*[IGFBP7] was significantly more discriminant than baseline SCr (AUC [95%CI]: 0.73 [0.63-0.84]; p = 0.005), and slightly but not significantly more discriminant than baseline UO (AUC [95%CI]: 0.86 [0.78‒0.94], p = 0.08) Combining the baseline [TIMP2]*[IGFBP7] with baseline SCr and UO significantly improved the latter markers' predictive performance.ConclusionUrine [TIMP-2]*[IGFBP7] effectively identify patients with a risk of severe AKI. Below a cut-off of 0.39 (ng/ml)2/1000, the risk of severe AKI is low.Copyright © 2019 Elsevier B.V. All rights reserved.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

Want more great medical articles?

Keep up to date with a free trial of metajournal, personalized for your practice.
1,694,794 articles already indexed!

We guarantee your privacy. Your email address will not be shared.