دورية أكاديمية
Cell cycle arrest biomarkers for predicting renal recovery from acute kidney injury: a prospective validation study.
العنوان: | Cell cycle arrest biomarkers for predicting renal recovery from acute kidney injury: a prospective validation study. |
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المؤلفون: | Jia HM; Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China., Cheng L; Department of Emergent Intensive Critical Unit, Beijing Lu-He Hospital, Capital Medical University, Beijing, 101100, China., Weng YB; Department of Emergent Intensive Critical Unit, Beijing Lu-He Hospital, Capital Medical University, Beijing, 101100, China., Wang JY; Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China., Zheng X; Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China., Jiang YJ; Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China., Xin X; Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China., Guo SY; Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China., Chen CD; Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China., Guo FX; Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China., Han YZ; Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China., Zhang TE; Gettysburg, PA, 17325, USA., Li WX; Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China. liwx1126@163.com. |
المصدر: | Annals of intensive care [Ann Intensive Care] 2022 Feb 12; Vol. 12 (1), pp. 14. Date of Electronic Publication: 2022 Feb 12. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 101562873 Publication Model: Electronic Cited Medium: Print ISSN: 2110-5820 (Print) Linking ISSN: 21105820 NLM ISO Abbreviation: Ann Intensive Care Subsets: PubMed not MEDLINE |
أسماء مطبوعة: | Original Publication: Heidelberg : Springer-Verlag, 2011- |
مستخلص: | Background: Acute kidney injury (AKI) is a common disease in the intensive care unit (ICU). AKI patients with nonrecovery of renal function have a markedly increased risk of death compared with patients with recovery. The current study aimed to explore and validate the utility of urinary cell cycle arrest biomarkers for predicting nonrecovery in patients who developed AKI after ICU admission. Methods: We prospectively and consecutively enrolled 379 critically ill patients who developed AKI after admission to the ICU, which were divided into a derivation cohort (194 AKI patients) and a validation cohort (185 AKI patients). The biomarkers of urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) were detected at inclusion immediately after AKI diagnosis (day 0) and 24 h later (day 1). The optimal cut-off values of these biomarkers for predicting nonrecovery were estimated in the derivation cohort, and their predictive accuracy was assessed in the validation cohort. The primary endpoint was nonrecovery from AKI (within 7 days). Results: Of 379 patients, 159 (41.9%) patients failed to recover from AKI onset, with 79 in the derivation cohort and 80 in the validation cohort. Urinary [TIMP-2]*[IGFBP7] on day 0 showed a better prediction ability for nonrecovery than TIMP-2 and IGFBP7 alone, with an area under the reciever operating characteristic curve (AUC) of 0.751 [95% confidence interval (CI) 0.701-0.852, p < 0.001] and an optimal cut-off value of 1.05 ((ng/mL) 2 /1000). When [TIMP-2]*[IGFBP7] was combined with the clinical factors of AKI diagnosed by the urine output (UO) criteria, AKI stage 2-3 and nonrenal SOFA score for predicting nonrecovery, the AUC was significantly improved to 0.852 (95% CI 0.750-0.891, p < 0.001), which achieved a sensitivity and specificity of 88.8% (72.9, 98.7) and 92.6% (80.8, 100.0), respectively. However, urine [TIMP-2]*[IGFBP7], TIMP-2 alone, and IGFBP7 alone on day 1 performed poorly for predicting AKI recovery. Conclusion: Urinary [TIMP-2]*[IGFBP7] on day 0 showed a fair performance for predicting nonrecovery from AKI. The predictive accuracy can be improved when urinary [TIMP-2]*[IGFBP7] is combined with the clinical factors of AKI diagnosed by the UO criteria, AKI stage 2-3 and nonrenal SOFA score. (© 2022. The Author(s).) |
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معلومات مُعتمدة: | Z191100006619032 Beijing Municipal Science & Technology Commission; Z181100001718204 Beijing Municipal Science & Technology Commission |
فهرسة مساهمة: | Keywords: Acute kidney injury; IGFBP7; Prognosis; Renal recovery; TIMP-2 |
تواريخ الأحداث: | Date Created: 20220212 Latest Revision: 20220830 |
رمز التحديث: | 20221213 |
مُعرف محوري في PubMed: | PMC8840946 |
DOI: | 10.1186/s13613-022-00989-8 |
PMID: | 35150348 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2110-5820 |
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DOI: | 10.1186/s13613-022-00989-8 |