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Urinary tissue inhibitor of metalloproteinase-2 and insulin-like growth factor-binding protein 7 as biomarkers of patients with established acute kidney injuryopen access

Authors
Cho, Won YongLim, Sung YoonYang, Ji HyunOh, Se WonKim, Myung-GyuJo, Sang-Kyung
Issue Date
May-2020
Publisher
대한내과학회
Keywords
Acute kidney injury; Biomarker; Tissue inhibitor metalloproteinase-2; Insulin-like growth factor-binding protein 7
Citation
The Korean Journal of Internal Medicine, v.35, no.3, pp.662 - 671
Indexed
SCIE
SCOPUS
KCI
Journal Title
The Korean Journal of Internal Medicine
Volume
35
Number
3
Start Page
662
End Page
671
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/838
DOI
10.3904/kjim.2018.266
ISSN
1226-3303
Abstract
Background/Aims Urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been recently discovered and validated as sensitive biomarkers that can predict stage 2 or 3 acute kidney injury (AKI) development in high-risk patients. We aimed to assess whether these biomarkers could predict adverse outcomes and renal recovery in established AKI patients. Methods This was a single-center study prospectively enrolling 124 patients diagnosed with AKI. TIMP-2, IGFBP7, neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury molecule 1 (KIM-1) levels were measured at the time of diagnosis and the predictive performance of short-term outcomes and renal recovery was assessed. Results Patients were divided into 4 quartiles according to the initial urinary TIMP-2/IGFBP7 levels. Stage 3 AKI (odds ratio [OR], 17.86), classified by the Kidney Disease Improving Global Outcomes (KDIGO), as well as the third and fourth quartiles of TIMP-2/IGFBP7 (OR, 5.75 and 44.98, respectively), were found to be independent predictors of renal replacement therapy at the time of AKI diagnosis. In addition, KDIGO stage 3 AKI (OR, 2.468) or the third of fourth quartiles of urinary TIMP-2/IGFBP7 (OR, 1.896 and 3.622, respectively) were also found to be useful in predicting nonrecovery of renal function. In a separate analysis of patients with renal recovery at discharge, initial urinary TIMP-2/IGFBP7 or urinary IGFBP7 at discharge could also predict new-onset or progressive chronic kidney disease (CKD). Conclusions In AKI patients, urine TIMP-2/IGFBP7 could serve as a biomarker for predicting adverse outcomes, renal recovery, or the development and progression of CKD.
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Kim, Myung Gyu
Anam Hospital (Department of Nephrology and Hypertension, Anam Hospital)
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