Abstract: SA-PO0073
Urinary TIMP2 * IGFBP7 and AKI After Cardiac Surgery in the TRIBE-AKI Multicenter Cohort
Session Information
- AKI: Clinical Diagnostics and Biomarkers
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Goeddel, Lee A., Johns Hopkins University, Baltimore, Maryland, United States
- Thiessen Philbrook, Heather, Johns Hopkins University, Baltimore, Maryland, United States
- Parikh, Manav C., University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Moledina, Dennis G., Yale University, New Haven, Connecticut, United States
- Coca, Steven G., Mount Sinai Health System, New York, New York, United States
- MacPhee, Iain, AstraZeneca PLC, Cambridge, England, United Kingdom
- Varma, Vijayalakshmi, AstraZeneca PLC, Cambridge, England, United Kingdom
- Pearce, Andy, AstraZeneca PLC, Cambridge, England, United Kingdom
- Parikh, Chirag R., Johns Hopkins University, Baltimore, Maryland, United States
Background
The urinary biomarker combination Tissue Inhibitor of Metalloproteinases-2 * Insulin-like Growth Factor Binding Protein-7 ((TIMP-2*IGFBP-7) has received FDA approval for predicting risk of moderate to severe acute kidney injury in the first 24 hours following cardiac surgery. The landmark TRIBE-AKI Multicenter cohort study has been instrumental in demonstrating the potential utility of various urinary biomarkers for patients undergoing cardiac surgery, but TIMP-2* IGFBP-7 has not been evaluated in TRIBE.
Methods
We conducted a case control sub-study of 400 participants in the TRIBE-AKI Cohort. Two hundred participants with and without AKI were randomly selected and urine TIMP-2* IGFBP-7 was measured at 4 timepoints (every 6 hours in the first 24 hours post-operatively). TIMP-2* IGFBP-7 values are reported as the AKIrisk score. Logistic regression assessed the association between AKIrisk score at 2 cut points (>0.30 and >2) with any AKI (>50% increase or >0.3mg/dL increase in serum creatinine from baseline) or severe AKI (>100% increase).
Results
The AKI group had more chronic kidney disease, diabetes, and congestive heart failure. At all-time points, the AKIrisk score (TIMP-2* IGFBP-7/1000) was higher in the AKI group compared to the non-AKI group (fig). The >0.3 cut off was associated with any AKI at 0-6, 6-12, and 12-18 hours, but not at 18-24 hours, and it was only associated with severe AKI at 0-6 hours (table). The >2 AKIrisk score cutoff was associated with any AKI and severe AKI at the 6-12, 12-18, and 18–24 hour timepoints. The >2 cut off was not associated with either outcome at the 0-6 hour timepoint.
Conclusion
In a sub study of the TRIBE-AKI cohort, TIMP-2* IGFBP-7 at several time points after surgery was associated with AKI and severe AKI using the >0.3 and >2 clinical cutoff values. The >0.3 may be more clinically relevant at the 0-6 hour time point and the >2 cutoff starting at the 6-12 hour timepoint.
Funding
- NIDDK Support