Biomarker rule-in or rule-out in patients with acute diseases for validation of acute kidney injury in the emergency department (brava): A multicenter study evaluating urinary timp-2/igfbp7
Background: Urine tissue inhibitor of metalloproteinases-2/insulin-like growth factor-binding protein 7 (TIMP-2/IGFBP7) (NephroCheck, Ortho Clinical Diagnostics, Raritan, NJ, USA) is a US Food and Drug Administration-approved biomarker for risk assessment of acute kidney injury (AKI) in critically i...
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th-mahidol.751482022-08-04T11:40:56Z Biomarker rule-in or rule-out in patients with acute diseases for validation of acute kidney injury in the emergency department (brava): A multicenter study evaluating urinary timp-2/igfbp7 Hyun Suk Yang Mina Hur Kyeong Ryong Lee Hanah Kim Hahn Young Kim Jong Won Kim Mui Teng Chua Win Sen Kuan Horng Ruey Chua Chagriya Kitiyakara Phatthranit Phattharapornjaroen Anchalee Chittamma Thiyapha Werayachankul Urmila Anandh Sanjeeva Herath Zoltan Endre Andrea Rita Horvath Paola Antonini Salvatore Di Somma Ramathibodi Hospital National University Health System Sapienza Università di Roma National University Hospital Konkuk University Graduate School of Medicine Burapha University Prince of Wales Hospital Yashoda Hospitals Medicine Background: Urine tissue inhibitor of metalloproteinases-2/insulin-like growth factor-binding protein 7 (TIMP-2/IGFBP7) (NephroCheck, Ortho Clinical Diagnostics, Raritan, NJ, USA) is a US Food and Drug Administration-approved biomarker for risk assessment of acute kidney injury (AKI) in critically ill adult patients in intensive care units; however, its clinical impact in the emergency department (ED) remains unproven. We evaluated the utility of NephroCheck for predicting AKI development and short-term mortality in the ED. Methods: This was a prospective, observational, five-center international study. We consecutively enrolled ED patients admitted with ≥30% risk of AKI development (assessed by ED physician: ED score) or acute diseases. Serum creatinine was tested on ED arrival (T0), day 1, and day 2 (T48); urine for NephroCheck was collected at T0 and T48. We performed ROC curve and reclassification analyses. Results: Among the 529 patients enrolled (213 females; median age, 65 years), AKI developed in 59 (11.2%) patients. The T0 NephroCheck value was higher in the AKI group than in the non-AKI group (median 0.77 vs. 0.29 (ng/m)2/1,000, P=0.001), and better predicted AKI development than the ED score (area under the curve [AUC], 0.64 vs. 0.53; P=0.04). In reclassification analyses, adding NephroCheck to the ED score improved the prediction of AKI development (P<0.05). The T0 NephroCheck value predicted 30-day mortality (AUC, 0.68; P<0.001). Conclusions: NephroCheck can predict both AKI development and short-term mortality in at-risk ED patients. NephroCheck would be a useful biomarker for early ruling-in or ruling-out of AKI in the ED. 2022-08-04T04:40:56Z 2022-08-04T04:40:56Z 2022-01-01 Article Annals of Laboratory Medicine. Vol.42, No.2 (2022), 178-187 10.3343/alm.2022.42.2.178 22343814 22343806 2-s2.0-85118275681 https://repository.li.mahidol.ac.th/handle/123456789/75148 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85118275681&origin=inward |
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Medicine Hyun Suk Yang Mina Hur Kyeong Ryong Lee Hanah Kim Hahn Young Kim Jong Won Kim Mui Teng Chua Win Sen Kuan Horng Ruey Chua Chagriya Kitiyakara Phatthranit Phattharapornjaroen Anchalee Chittamma Thiyapha Werayachankul Urmila Anandh Sanjeeva Herath Zoltan Endre Andrea Rita Horvath Paola Antonini Salvatore Di Somma Biomarker rule-in or rule-out in patients with acute diseases for validation of acute kidney injury in the emergency department (brava): A multicenter study evaluating urinary timp-2/igfbp7 |
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Background: Urine tissue inhibitor of metalloproteinases-2/insulin-like growth factor-binding protein 7 (TIMP-2/IGFBP7) (NephroCheck, Ortho Clinical Diagnostics, Raritan, NJ, USA) is a US Food and Drug Administration-approved biomarker for risk assessment of acute kidney injury (AKI) in critically ill adult patients in intensive care units; however, its clinical impact in the emergency department (ED) remains unproven. We evaluated the utility of NephroCheck for predicting AKI development and short-term mortality in the ED. Methods: This was a prospective, observational, five-center international study. We consecutively enrolled ED patients admitted with ≥30% risk of AKI development (assessed by ED physician: ED score) or acute diseases. Serum creatinine was tested on ED arrival (T0), day 1, and day 2 (T48); urine for NephroCheck was collected at T0 and T48. We performed ROC curve and reclassification analyses. Results: Among the 529 patients enrolled (213 females; median age, 65 years), AKI developed in 59 (11.2%) patients. The T0 NephroCheck value was higher in the AKI group than in the non-AKI group (median 0.77 vs. 0.29 (ng/m)2/1,000, P=0.001), and better predicted AKI development than the ED score (area under the curve [AUC], 0.64 vs. 0.53; P=0.04). In reclassification analyses, adding NephroCheck to the ED score improved the prediction of AKI development (P<0.05). The T0 NephroCheck value predicted 30-day mortality (AUC, 0.68; P<0.001). Conclusions: NephroCheck can predict both AKI development and short-term mortality in at-risk ED patients. NephroCheck would be a useful biomarker for early ruling-in or ruling-out of AKI in the ED. |
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Ramathibodi Hospital |
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Ramathibodi Hospital Hyun Suk Yang Mina Hur Kyeong Ryong Lee Hanah Kim Hahn Young Kim Jong Won Kim Mui Teng Chua Win Sen Kuan Horng Ruey Chua Chagriya Kitiyakara Phatthranit Phattharapornjaroen Anchalee Chittamma Thiyapha Werayachankul Urmila Anandh Sanjeeva Herath Zoltan Endre Andrea Rita Horvath Paola Antonini Salvatore Di Somma |
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Hyun Suk Yang Mina Hur Kyeong Ryong Lee Hanah Kim Hahn Young Kim Jong Won Kim Mui Teng Chua Win Sen Kuan Horng Ruey Chua Chagriya Kitiyakara Phatthranit Phattharapornjaroen Anchalee Chittamma Thiyapha Werayachankul Urmila Anandh Sanjeeva Herath Zoltan Endre Andrea Rita Horvath Paola Antonini Salvatore Di Somma |
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Hyun Suk Yang |
title |
Biomarker rule-in or rule-out in patients with acute diseases for validation of acute kidney injury in the emergency department (brava): A multicenter study evaluating urinary timp-2/igfbp7 |
title_short |
Biomarker rule-in or rule-out in patients with acute diseases for validation of acute kidney injury in the emergency department (brava): A multicenter study evaluating urinary timp-2/igfbp7 |
title_full |
Biomarker rule-in or rule-out in patients with acute diseases for validation of acute kidney injury in the emergency department (brava): A multicenter study evaluating urinary timp-2/igfbp7 |
title_fullStr |
Biomarker rule-in or rule-out in patients with acute diseases for validation of acute kidney injury in the emergency department (brava): A multicenter study evaluating urinary timp-2/igfbp7 |
title_full_unstemmed |
Biomarker rule-in or rule-out in patients with acute diseases for validation of acute kidney injury in the emergency department (brava): A multicenter study evaluating urinary timp-2/igfbp7 |
title_sort |
biomarker rule-in or rule-out in patients with acute diseases for validation of acute kidney injury in the emergency department (brava): a multicenter study evaluating urinary timp-2/igfbp7 |
publishDate |
2022 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/75148 |
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1763493771309219840 |