The cell cycle biomarkers: promising research, but do not oversell them.
This review focuses on the most recent scientific and clinical information on the development and clinical applicability of the cell cycle biomarkers TIMP-2 and IGFBP-7 in the diagnosis and prognosis of patients at risk for and suffering from acute kidney injury (AKI). A number of evaluation studies have demonstrated that compared with existing biomarkers, urinary excretion of the product of both biomarkers, [TIMP-2]•[IGFBP-7], improved diagnostic performance in assessing the risk for AKI, predicting the need for renal replacement therapy, AKI-related complications and short- and long-term prognoses. The reference intervals for these biomarkers, measured by the recently approved NephroCheck test, have been determined in apparently healthy adults and those with stable chronic morbid conditions without AKI. This review recognizes that the combination of these two cell cycle arrest markers for the early detection of AKI is promising but concludes that its clinical impact is still unproved. Clinicians should understand the utility and limitations of this test before deciding whether to make it available at their institution.
Renal Division, Department of Medicine , University Hospital , 185, De Pintelaan, Gent 9000 , Belgium.
Norbert
N
Lameire
Renal Division, Department of Medicine , University Hospital , 185, De Pintelaan, Gent 9000 , Belgium.
Jill
J
Vanmassenhove
Renal Division, Department of Medicine , University Hospital , 185, De Pintelaan, Gent 9000 , Belgium.
Wim
W
Van Biesen
Renal Division, Department of Medicine , University Hospital , 185, De Pintelaan, Gent 9000 , Belgium.
Raymond
R
Vanholder
AKI; biomarkers; creatinine; glomerulosclerosis; prognosis