title: Urinary Biomarkers IGFBP7 and TIMP-2 for the Diagnostic Assessment of Transient and Persistent Acute Kidney Injury in Critically Ill Patients.
abstract: OBJECTIVE
  The capability of urinary TIMP-2 (tissue inhibitor of metalloproteinase) and IGFBP7 (insulin-like growth factor binding protein)-NephroCheck Test (NC) = ([TIMP-2] x [IGFBP7]) / 1000)-to predict renal recovery from acute kidney injury (AKI) has been poorly studied. The aim of this study was to assess the performance of measurements of ([TIMP-2] x [IGFBP7]) / 1000) over 24 hours to differentiate transient from persistent AKI.
  
  
  METHODS
  Of 460 consecutive adult patients admitted to the ICU, 101 were prospectively studied: 56 men, 62 (52-71) years old. A fresh urine sample was collected at H0, H4, H12 and H24 to determine ([TIMP-2] x [IGFBP7]) / 1000) levels. Areas under the curves of Delta NC H4-Ho and H12-H4 and serum creatinine (sCr) for detection of AKI recovery were compared.
  
  
  RESULTS
  Forty-one (40.6%) patient were diagnosed with AKI: 27 transient and 14 persistent AKI. At admission (H0), AKI patients had a significantly higher NC score than patients without AKI (0.43 [0.07-2.06] vs 0.15 [0.07-0.35], p = 0.027). In AKI groups, transient AKI have a higher NC, at H0 and H4, than persistent AKI (0.87 [0.09-2.82] vs 0.13 [0.05-0.66] p = 0.035 and 0.13 [0.07-0.61] vs 0.05 [0.02-0.13] p = 0.013). Thereafter, NC level decreased in both AKI groups with a Delta NC score H4-H0 and H12-H4 significantly more important in transient AKI. Roc curves showed however that delta NC scores did not discriminate between transient and persistent AKI.
  
  
  CONCLUSIONS
  In our population, absolute urinary levels of NC score were higher at early hours after ICU admission (H0 and H4) in transient AKI as compared to persistent AKI patients. NC variations (Delta NC scores) over the first 12 hours may indicate the AKI's evolving nature with a more significant decrease in case of transient AKI but were not able to differentiate transient from persistent AKI.
authors.affiliation: Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Daubin
authors.affiliation: Department of Biochemistry, Lapeyronie University Hospital, Montpellier, France.|PhyMedExp, Centre National de la Recherche Scientifique (CNRS 9214) - Institut National de la Santé et de la Recherche Médicale (INSERM U-1046), Montpellier University, Montpellier, France.
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Cristol
authors.affiliation: Department of Biochemistry, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Dupuy
authors.affiliation: Department of Biochemistry, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Nils
authors.initials: N
authors.lastname: Kuster
authors.affiliation: Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Noémie
authors.initials: N
authors.lastname: Besnard
authors.affiliation: Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Laura
authors.initials: L
authors.lastname: Platon
authors.affiliation: Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Aurèle
authors.initials: A
authors.lastname: Buzançais
authors.affiliation: Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Brunot
authors.affiliation: Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Garnier
authors.affiliation: Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Jonquet
authors.affiliation: Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France.|PhyMedExp, Centre National de la Recherche Scientifique (CNRS 9214) - Institut National de la Santé et de la Recherche Médicale (INSERM U-1046), Montpellier University, Montpellier, France.
authors.forename: Kada
authors.initials: K
authors.lastname: Klouche
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000652:urine*; D000368:Aged; D015415:Biomarkers / Q000652:urine*; D016638:Critical Illness; D005260:Female; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins / Q000652:urine*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000652:urine*
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