Common chronic conditions do not affect performance of cell cycle arrest biomarkers for risk stratification of acute kidney injury

Michael Heung, Luis M. Ortega, Lakhmir S. Chawla, Richard G. Wunderink, Wesley H. Self, Jay L. Koyner, Jing Shi, John A. Kellum*

*Corresponding author for this work

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Background Identification of acute kidney injury (AKI) can be challenging in patients with underlying chronic disease, and biomarkers often perform poorly in this population. In this study we examined the performance characteristics of the novel biomarker panel of urinary tissue inhibitor of metalloproteinases-2 (TIMP2) and insulin-like growth factor-binding protein 7 ([IGFBP7]) in patients with a variety of comorbid conditions. Methods We analyzed data from two multicenter studies of critically ill patients in which [TIMP2]•[IGFBP7] was validated for prediction of Kidney Disease: Improving Global Outcomes (KDIGO) Stage 2 or 3 AKI within 12 h. We constructed receiver operating characteristic (ROC) curves for AKI prediction both overall and by comorbid conditions common among patients with AKI, including diabetes mellitus, congestive heart failure (CHF) and chronic kidney disease (CKD). Results In the overall cohort of 1131 patients, 139 (12.3%) developed KDIGO Stage 2 or 3 AKI. [TIMP2]•[IGFBP7] was significantly higher in AKI versus non-AKI patients, both overall and within each comorbidity subgroup. The AUC for [TIMP2]•[IGFBP7] in predicting AKI was 0.81 overall. Higher AUC was noted in patients with versus without CHF (0.89 versus 0.79; P = 0.026) and CKD (0.91 versus 0.80; P = 0.024). Conclusions We observed no significant impairment in the performance of cell cycle arrest biomarkers due to the presence of chronic comorbid conditions.

Original languageEnglish (US)
Pages (from-to)1633-1640
Number of pages8
JournalNephrology Dialysis Transplantation
Volume31
Issue number10
DOIs
StatePublished - Oct 1 2016

Keywords

  • acute kidney injury
  • biomarkers
  • chronic kidney disease

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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