TIMP2 and IGFBP-7 as Biomarkers For The Diagnosis of Acute Kidney Injury (AKI) in Post-operative Patients: An Evidence-Based Case Report
Abstract
Background: Acute kidney injury (AKI) is defined as a sudden reduction in kidney function which commonly occurs as a complication of major surgeries. It is traditionally diagnosed using serum creatinine elevation. AKI has relatively slow kinetics that makes it unable to diagnose at an earlier more reversible stage. Furthermore, previous research has shown that TIMP-2 and IGFBP7 were urinary biomarkers to use as a diagnostic tool for AKI. We aimed to compare the accuracy of TIMP2 and IGFBP-7 to the gold standard (serum creatinine) in diagnosing AKI in postoperative patients. Methods: A thorough search was performed using a search strategy on EMBASE, PubMed, and Medline (Ovid) using keywords according to the objective. The collected articles were critically appraised using CEEBM critical appraisal tool. Results: 5 studies that fulfilled the inclusion criteria were selected and evaluated. They all stated that the use of TIMP2 and IGFBP7 could not detect AKI better than the gold standard as shown in the sensitivity and specificity of the biomarkers. Furthermore, the examination of AKI using both biomarkers showed a sensitivity of 60-100% and specificity of 58-91%. Conclusion: TIMP2 and IGFBP7 are promising diagnostic tools for AKI. However, due to the wide variation in results amongst the different studies, further research is required to ensure the credibility of this result.
Keywords
References
Prowle JR, Forni LG, Bell M, et al. Postoperative acute kidney injury in adult non-cardiac surgery: joint consensus report of the acute disease quality initiative and perioperative quality initiative. Nat Rev Nephrol. 2021;17(9):605–18.
Waikar SS, Betensky RA, Emerson SC, Bonventre JV. Imperfect gold standards for kidney injury biomarker evaluation. J Am Soc Nephrol. 2012;23(1):13–21.
Gunnerson KJ, Shaw AD, Chawla LS, et al. TIMP2•IGFBP7 biomarker panel accurately predicts acute kidney injury in high-risk surgical patients. J Trauma Acute Care Surg. 2016;80(2):243–9.
Esmeijer K, Schoe A, Ruhaak LR, et al. The predictive value of TIMP-2 and IGFBP7 for kidney failure and 30-day mortality after elective cardiac surgery. Sci Rep. 2021;11(1):1071.
KDIGO. KDIGO international supplements. International Society of Nephrology. 2012; 2(1):1-141.
Oezkur M, Magyar A, Thomas P, et al. TIMP-2*IGFBP7 (Nephrocheck®) measurements at intensive care unit admission after cardiac surgery are predictive for acute kidney injury within 48 hours. Kidney Blood Press Res. 2017;42(3):456–67.
Mayer T, Bolliger D, Scholz M, et al. Urine biomarkers of tubular renal cell damage for the prediction of acute kidney injury after cardiac surgery-a pilot study. J Cardiothorac Vasc Anesth. 2017;31(6):2072–9.
Meersch M, Schmidt C, Van Aken H, et al. Urinary TIMP-2 and IGFBP7 as early biomarkers of acute kidney injury and renal recovery following cardiac surgery. PLoS One. 2014;9(3):e93460.
Dusse F, Edayadiyil-Dudásova M, Thielmann M, et al. Early prediction of acute kidney injury after transapical and transaortic aortic valve implantation with urinary G1 cell cycle arrest biomarkers. BMC Anesthesiol. 2016;16:76.
Pilarczyk K, Edayadiyil-Dudasova M, Wendt D, et al. Urinary [TIMP-2]*[IGFBP7] for early prediction of acute kidney injury after coronary artery bypass surgery. Ann Intensive Care. 2015;5(1):50.
Gocze I, Koch M, Renner P, et al. Urinary biomarkers TIMP-2 and IGFBP7 early predict acute kidney injury after major surgery. PLoS One. 2015;10(3):e0120863.
Vijayan A, Faubel S, Askenazi DJ, et al. Clinical use of the urine biomarker [TIMP-2] × [IGFBP7] for acute kidney injury risk assessment. Am J Kidney Dis. 2016;68(1):19–28.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a