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ABSTRACT: Background
Biomarkers can play a critical role by facilitating diagnosis and stratification of disease, as well as assessment or prediction of disease severity. Urinary tissue inhibitor of metalloproteinase-2 and insulin-like growth factor binding protein 7 product ([TIMP-2]?×?[IGFBP7]) predict the development and progression of AKI and recently procalcitonin (PCT), a widely used biomarker for sepsis diagnosis and management, has been associated with AKI occurrence in ICU patients. To assess combinations of [TIMP-2]?×?[IGFBP7] and PCT results for prediction and risk stratification of short-term outcomes in septic and non-septic patients, a retrospective cohort analysis of critically ill patients was performed in a multidisciplinary ICU. ROC curve analysis was used in order to evaluate predictive performance of combined results of [TIMP-2]?×?[IGFBP7] and PCT at the time of admission for AKI development. To verify the utility of adding [TIMP-2]?×?[IGFBP7] and PCT results for risk assessment, we evaluated the predictive value of having a single-marker positivity compared to a double-marker positivity using the widely used cut-off of 0.3 (ng/mL)2/1000 for [TIMP-2]?×?[IGFBP7] and 0.5 ?g/L for PCT. Risk assessment for AKI occurrence within 48 h, acute kidney disease (AKD) and mortality at 7 days was performed by logistic/Cox regression analysis.Results
433 patients were analysed, of whom 168 had AKI within 48 h (93 septic and 65 non-septic patients). Combination of [TIMP-2]?×?[IGFBP7] and PCT showed a good predictive ability for AKI occurrence (AUC 0.81, 95% CI 0.77-0.86, p?ConclusionsAlthough combining the results of [TIMP-2]?×?[IGFBP7] and PCT may be a useful tool to identify and stratify ICU patients at high risk for septic AKI and short-term adverse outcomes, data should be confirmed in a large prospective study.
SUBMITTER: Godi I
PROVIDER: S-EPMC7174532 | biostudies-literature | 2020 Apr
REPOSITORIES: biostudies-literature
Godi Ilaria I De Rosa Silvia S Martino Francesca F Bazzano Simona S Martin Marina M Boni Elisa E Carta Maria Rosa MR Tamayo Diaz Claudia C Mari Gaia G Lorenzin Anna A de Cal Massimo M Corradi Valentina V Caprara Carlotta C Giavarina Davide D Ronco Claudio C
Annals of intensive care 20200421 1
<h4>Background</h4>Biomarkers can play a critical role by facilitating diagnosis and stratification of disease, as well as assessment or prediction of disease severity. Urinary tissue inhibitor of metalloproteinase-2 and insulin-like growth factor binding protein 7 product ([TIMP-2] × [IGFBP7]) predict the development and progression of AKI and recently procalcitonin (PCT), a widely used biomarker for sepsis diagnosis and management, has been associated with AKI occurrence in ICU patients. To as ...[more]