Tissue inhibitor metalloproteinase-2 (TIMP-2) • IGF-binding protein-7 (IGFBP7) levels are associated with adverse outcomes in patients in the intensive care unit with acute kidney injury

The G1 cell cycle inhibitors tissue inhibitor metalloproteinase-2 (TIMP-2)and insulin-like growth factor-binding protein 7 (IGFBP7)have been identified as novel biomarkers for the prediction of moderate to severe acute kidney injury (AKI)risk. However, the prognostic value of [TIMP-2]•[IGFBP7]in predicting adverse outcomes in intensive care unit (ICU)patients with AKI was not previously described. To evaluate this, we conducted a cohort study, measuring [TIMP2]•[IGFBP7]levels in critically ill patients admitted to the ICU and classified the patients as NephroCheck (NC)(+)or NC (-)according to [TIMP-2]•[IGFBP7]values and AKI (+)or AKI (-)according to Kidney Disease: Improving Global Outcomes (KDIGO)criteria. We then evaluated the incidence of continuous renal replacement therapy initiation, all-cause mortality and a composite endpoint of both in the four groups. Baseline [TIMP-2]•[IGFBP7]values were available for 719 patients, of whom 239 developed AKI and 151 met the composite endpoint...