Early Diagnostic and Prognostic Value of the Urinary TIMP-2 and IGFBP-7 in Acute Kidney Injury in Critically Ill Children
Year: 2024
Type: article
Study design: Observational Study
Abstract: Background: Acute kidney injury (AKI) is a hidden complication among children within pediatric intensive care units (PICU).Aim: To evaluate the early predictive and diagnostic value of Urinary [TIMP-2]•[IGFBP7] to detect AKI in PICU patients.Methods: A case-control study was conducted on 112 children (72 admitted to PICU and 40 healthy controls) Urinary [TIMP-2]•[IGFBP7] was measured within 24 hours of PICU admission.Results: Acute kidney injury developed in 52 (72.2%) out of 72 critically ill patients.The AKI group had significantly higher serum creatinine, CRP, and pediatric sequential organ failure assessment score (pSOFA) score (p = 0.001, 0.01, and 0.001, respectively) and significantly lower estimated creatinine clearance (eCCl) (p = 0.001).Urinary [TIMP-2]•[IGFBP7] was significantly higher in the AKI group as compared with the non-AKI group (p = 0.007) .The duration of the PICU stay was 1.8-fold higher in the AKI group (p = 0.004).At the time of study enrollment, 7 (13.5%)patients had normal initial eCCl.26 patients (50.0%) fulfilled the "Risk, " 18 patients (34.6%) the "Injury, " 1 patient (1.9%) the "Failure" and 0 patient (0%) the "Loss" criteria.Nine (17%) patients progressed to the next higher pediatrics risk, injury, failure, loss, end-stage renal disease (pRIFLE) stage.Urinary [TIMP-2]•[IGFBP7] was significantly higher in the "Failure" stage followed by "Injury, " stage then the "Risk, " stage (p = 0.001).Hypovolemia/ dehydration had the highest [TIMP-2]•[IGFBP7] values followed by sepsis.Urinary [TIMP-2]•[IGFBP7] was significantly increased in mechanically ventilated and patients who received inotropic medications.Conclusions: [TIMP-2]•[IGFBP7] was higher in AKI patients compared with non-AKI ones especially cases with hypovolemia and sepsis.It may predict severe morbidity and mortality because its higher levels in mechanically ventilated children and those on positive inotropic support.
Authors: Mervat Ismail, Nehal Abdelhamid, Hasanin M Hasanin, Hanan M Hamed, Ayat A Motawie, Solaf Kamel, Eman M Hassan, Radwa S Iraqy
Institutions: National Research Centre, Cairo University
Language: English
Topic: Acute Kidney Injury Research
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4402991209