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CuarteroM.pdf (1.1 MB)

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2017-09-07

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cc by (c) Cuartero et al., 2017
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/124267

Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients

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https://doi.org/10.1186/s13613-017-0317-y

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Purpose: To analyse the usefulness of the composite index of the tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) as urinary biomarkers for the early prediction of AKI in septic and non-septic patients. Methods: This is a prospective, observational study including patients admitted to ICU from acute care departments and hospital length of stay < 48 h. The main exclusion criteria were pre-existing eGFR < 30 mL/min/1.73 m(2) and hospitalisation 2 months prior to current admission. The [TIMP-2].[IGFBP7] index was analysed twice, within the first 12 h of ICU admission. Results: The sample included 98 patients. AKI incidence during ICU stay was 50%. Sepsis was diagnosed in 40.8%. Baseline renal variables were comparable between subgroups except for a higher baseline eGFR in non-septic patients. Patients were stratified based on the presence of AKI and their highest level of [TIMP-2].[IGFBP7] within the first 12 h of stay. [TIMP-2].[IGFBP7] index values were dependent on the incidence of AKI but not of sepsis. [TIMP2] .[IGFBP7] values were significantly related to AKI severity according to AKIN criteria (p < 0.0001). The AUROC curve to predict AKI of the worst [TIMP-2].[IGFBP7] index value was 0.798 (sensitivity 73.5%, specificity 71.4%, p < 0.0001). Index values below 0.8 ruled out any need for renal replacement (NPV 100%), whereas an index > 0.8 predicted a rate of AKI of 71% and AKIN >= 2 of 62.9%. Conclusions: In our study, urinary [TIMP-2].[IGFBP7] was an early predictor of AKI in ICU patients regardless of sepsis. Besides, index values < 0.8(ng/mL)(2)/1000 ruled out the need for renal replacement.

Matèries

Marcadors bioquímics, Insuficiència renal aguda

Matèries (anglès)

Biochemical markers, Acute renal failure

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Col·leccions

Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

CUARTERO, Mireia, et al. Cell-cycle arrest biomarkers in urine to predict acute kidney injury in septic and non-septic critically ill patients. Annals Of Intensive Care. 2017. Vol. 7, num. 92. [consulted: 15 of August of 2026]. Available at: https://hdl.handle.net/2445/124267

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