Abstract | OBJECTIVES: DESIGN: SETTING: Two ICUs at Heidelberg University Hospital between May 2017 and July 2018. PATIENTS: INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Nineteen patients required renal replacement therapy. Diagnostic performance of urinary [TIMP-2] × [IGFBP7] improved over time with the highest area under the receiver operating characteristic curve of 0.89 (95% CI, 0.80-0.98) 24 hours after study inclusion. Soluble urokinase-type plasminogen activator receptor levels at inclusion showed an area under the receiver operating characteristic curve of 0.83 (0.75-0.92). The best discrimination ability for the primary outcome measure was achieved for [TIMP-2] × [IGFBP7] at 24 hours after inclusion by applying a cutoff value of greater than or equal to 0.6 (ng/mL)/1,000 (sensitivity 90.9, specificity 67.1). Soluble urokinase-type plasminogen activator receptor performed best by using a cutoff value of greater than or equal to 8.53 ng/mL (sensitivity 84.2, specificity 82.7). A combination of newly tested biomarkers with cystatin C resulted in a significantly improved diagnostic accuracy. Cystatin C in combination with [TIMP-2] × [IGFBP7] 24 hours outperformed all standard renal parameters (area under the receiver operating characteristic curve 0.93 [0.86-1.00]). CONCLUSIONS:
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Authors | Christian Nusshag, Christoph Rupp, Felix Schmitt, Ellen Krautkrämer, Claudius Speer, Florian Kälble, Sandra Tamulyte, Thomas Bruckner, Martin Zeier, Jochen Reiser, Markus A Weigand, Florian Uhle, Uta Merle, Christian Morath, Thorsten Brenner |
Journal | Critical care medicine
(Crit Care Med)
Vol. 47
Issue 12
Pg. e999-e1007
(12 2019)
ISSN: 1530-0293 [Electronic] United States |
PMID | 31584458
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers
- Insulin-Like Growth Factor Binding Proteins
- PLAUR protein, human
- Receptors, Urokinase Plasminogen Activator
- insulin-like growth factor binding protein-related protein 1
- Tissue Inhibitor of Metalloproteinase-2
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Topics |
- Acute Kidney Injury
(blood, diagnosis, etiology, therapy)
- Aged
- Biomarkers
(blood)
- Female
- Humans
- Insulin-Like Growth Factor Binding Proteins
(blood)
- Male
- Middle Aged
- Predictive Value of Tests
- Prospective Studies
- Receptors, Urokinase Plasminogen Activator
(blood)
- Renal Replacement Therapy
- Sepsis
(blood, complications)
- Tissue Inhibitor of Metalloproteinase-2
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