title: NephroCheck data compared to serum creatinine in various clinical settings.
abstract: BACKGROUND
  Acute kidney injury is frequently observed at the intensive care unit, after surgery, and after toxic drug administration. A rise in serum creatinine and a fall in urine output are consequences of much earlier injury to the most sensitive part of tubular cells located at the proximal tubule. The aim of the present study was to investigate the course of two cell-cycle arrest urinary biomarkers compared to serum creatinine in four clinical settings: ischemic reperfusion injury, cardiac failure, severe acute kidney injury, and chemotherapy-induced kidney injury.
  
  
  METHODS
  A recently developed bedside test known as NephroCheck measures two urinary parameters: insulin-like growth factor binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinase-2 (TIMP-2). The test is based on a sandwich immunoassay technique. The final test output, labeled AKIRisk, is shown as a numeric result.
  
  
  RESULTS
  This report revealed that [IGFBP7] · [TIMP-2] in urine rise rapidly prior to any change in serum creatinine. A unique feature of all four clinical settings is that a rapid decline predicts the recovery of kidney function. Besides, a subclinical kidney injury might be detected by the test.
  
  
  CONCLUSIONS
  This bedside test detects biomarkers of renal injury. A rapid decline in AKIRisk was associated with the restoration of kidney function, whereas a prolonged high AKIRisk score was associated with end-stage renal disease. However, the dynamics seem to differ, depending on the cause and the extent of injury. Further studies will be needed to clarify the issue.
authors.affiliation: Division of Nephrology and Dialysis, Department of Internal Medicine III, Vienna General Hospital, Waehringer Guertel 18-20, 1090, Vienna, Austria. sahra.pajenda@meduniwien.ac.at.
authors.forename: Sahra
authors.initials: S
authors.lastname: Pajenda
authors.affiliation: Division of Oncology, Department of Internal Medicine I, Vienna General Hospital, Waehringer Guertel 18-20, 1090, Vienna, Austria. aysegul.ilhan-mutlu@meduniwien.ac.at.
authors.forename: Aysegül
authors.initials: A
authors.lastname: Ilhan-Mutlu
authors.affiliation: Division of Oncology, Department of Internal Medicine I, Vienna General Hospital, Waehringer Guertel 18-20, 1090, Vienna, Austria. Matthias.preusser@meduniwien.ac.at.
authors.forename: Matthias
authors.initials: M
authors.lastname: Preusser
authors.affiliation: Division of Transplant Surgery, Department of Surgery, Vienna General Hospital, Waehringer Guertel 18-20, 1090, Vienna, Austria. sebastian.roka@meduniwien.ac.at.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Roka
authors.affiliation: Division of Nephrology and Dialysis, Department of Internal Medicine III, Vienna General Hospital, Waehringer Guertel 18-20, 1090, Vienna, Austria. wilfred.druml@meduniwien.ac.at.
authors.forename: Wilfred
authors.initials: W
authors.lastname: Druml
authors.affiliation: Division of Nephrology and Dialysis, Department of Internal Medicine III, Vienna General Hospital, Waehringer Guertel 18-20, 1090, Vienna, Austria. ludwig.wagner@meduniwien.ac.at.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Wagner
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000209:etiology / Q000652:urine*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000652:urine; D003404:Creatinine / Q000097:blood*; D005260:Female; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins / Q000652:urine*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000652:urine*; D016482:Urinalysis / Q000379:methods
chemical_list: D015415:Biomarkers; D018969:Insulin-Like Growth Factor Binding Proteins; C560823:TIMP2 protein, human; C102529:insulin-like growth factor binding protein-related protein 1; D019716:Tissue Inhibitor of Metalloproteinase-2; D003404:Creatinine