Abstract
BackgroundThe product of the concentrations of urinary tissue inhibitor of metalloproteinases-2 and insulin-like growth factor binding protein-7 (urinary [TIMP-2] × [IGFBP-7]) has been suggested as biomarker for early detection of acute kidney injury (AKI) in various clinical settings. However, the performance of urinary [TIMP-2] × [IGFBP-7] to predict AKI has never been assessed in patients undergoing orthotopic liver transplantation (OLT). Thus, the aim of this study was to assess the early predictive value of urinary [TIMP-2] × [IGFBP-7] for the development of AKI after OLT.MethodsIn this observational study, urinary [TIMP-2] × [IGFBP-7] was measured in samples from adult OLT patients. AKI was diagnosed and classified according to KDIGO criteria. Areas under the receiver operating curves (AUC) were calculated to assess predictive values of urinary [TIMP-2] × [IGFBP-7] for the development of AKI.ResultsForty patients (mean age 55 ± 8 years) were included. Twenty-eight patients (70%) developed AKI stage 1, 2, or 3 within 48 h after OLT. Urinary [TIMP-2] × [IGFBP-7] was not predictive for AKI at the end of OLT (AUC: 0.54, CI [0.32–0.75], P = 0.72), at day 1 (AUC: 0.60, CI [0.41–0.79], P = 0.31), or day 2 after OLT (AUC: 0.63, CI [0.46–0.8], P = 0.18).ConclusionBased on our results, routine clinical use of urinary [TIMP-2] × [IGFBP-7] cannot be recommended for risk assessment of AKI in patients undergoing OLT.
Highlights
The product of the concentrations of urinary tissue inhibitor of metalloproteinases-2 and insulin-like growth factor binding protein-7 has been suggested as biomarker for early detection of acute kidney injury (AKI) in various clinical settings
Other than a higher model for end-stage liver disease (MELD) score due to increased serum creatinine (sCr) and need of preoperative renal replacement therapy (RRT), the characteristics of the excluded patients did not differ from the rest of study population
Predictive value for AKI after orthotopic liver transplantation (OLT) In order to evaluate the predictive value of urinary [tissue inhibitor of metalloproteinases-2 (TIMP-2)] × [insulinlike growth factor binding protein-7 (IGFBP-7)] for the development of AKI within 48 h after OLT, receiver operating characteristics (ROC) curve analyses were performed
Summary
The product of the concentrations of urinary tissue inhibitor of metalloproteinases-2 and insulin-like growth factor binding protein-7 (urinary [TIMP-2] × [IGFBP-7]) has been suggested as biomarker for early detection of acute kidney injury (AKI) in various clinical settings. The performance of urinary [TIMP-2] × [IGFBP-7] to predict AKI has never been assessed in patients undergoing orthotopic liver transplantation (OLT). Changes in serum creatinine (sCr) concentrations and urine output are used to evaluate and diagnose AKI [11]. These “traditional” kidney parameters have limitations related to early and accurate identification of AKI [12]. SCr has limitations when used as a marker to diagnose AKI in patients with end-stage liver disease (ESLD) undergoing OLT. The need for massive fluid or blood products transfusion during
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
