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Abstract: FR-PO070

Use of TIMP-2 and IGFBP-7 for Prediction of AKI After Cardiac Surgery

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Delijani, David, Northwell Health, New Hyde Park, New York, United States
  • Yu, Pey-Jen, Dept of Cardiothoracic Surgery, Manhasset, New York, United States
  • Hirsch, Jamie S., Division of Kidney Diseases and HTN, Great Neck, New York, United States
  • Fishbane, Steven, Division of Kidney Diseases and HTN, Great Neck, New York, United States
  • Sharma, Purva D., Division of Kidney Diseases and HTN, Great Neck, New York, United States
  • Chang, Tylis, Northwell Health, New Hyde Park, New York, United States
  • Hartman, Alan, Dept of Cardiothoracic Surgery, Manhasset, New York, United States
  • Cassiere, Hugh, Dept of Cardiothoracic Surgery, Manhasset, New York, United States
  • Jhaveri, Kenar D., Division of Kidney Diseases and HTN, Great Neck, New York, United States
Background

Cell cycle arrest urinary biomarkers, tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP-7) have been used for early detection of acute kidney injury (AKI) in critically ill patients. The purpose of this study was to validate the use of these urinary biomarkers in patients undergoing open heart surgery.

Methods

In a single center prospective observational study, urine samples were collected in 108 consecutive patients who underwent open heart surgery. Immediately after separation from cardiopulmonary bypass and on postoperative day one, and were sent for the biomarker [TIMP2]*[IGFBP7]. Acute kidney injury was defined based on KDIGO criteria and levels of [TIMP2]*[IGFBP7] were analyzed for the ability to predict AKI.

Results

Of the 108 patients, 19 (17.6%) patients developed postoperative AKI within 48 hours of surgery. At the threshold of >0.3 (ng/mL)2 /1000, post-cardiopulmonary bypass [TIMP2]*[IGFBP-7] had a sensitivity of 13% and specificity of 82% for predicting postoperative AKI. Postoperative day 1 [TIMP-2]*[IGFBP-7] had a sensitivity of 47% and a specificity of 59% for predicting postoperative AKI. There were no differences in [TIMP-2]*[IGFBP-7] values at either time points between patients that developed postoperative AKI as compared to those that did not. (Figure). Limitations include a single center study and small sample size.

Conclusion

Urinary [TIMP-2]*[IGFBP7] was not predictive of the risk of AKI after cardiac surgery in this study population. More studies are needed to confirm these markers for AKI after cardiac surgery.

Box and whisker plots comparing median and interquartile range of urinary [TIMP-2]*[IGFBP7] levels between patients with and without AKI at different time points. A: Immediately after separation from cardiopulmonary bypass. B: Postoperative day one. C: Maximum value of separation from cardiopulmonary bypass and Postoperative day one.