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
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 pat...
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| Published in | Annals of laboratory medicine Vol. 42; no. 2; pp. 178 - 187 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Korea (South)
Korean Society for Laboratory Medicine
01.03.2022
대한진단검사의학회 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2234-3806 2234-3814 2234-3814 |
| DOI | 10.3343/alm.2022.42.2.178 |
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| Abstract | 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.
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.
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)
/1,000, P=0.001), and better predicted AKI development than the ED score (area under the curve [AUC], 0.64 vs. 0.53;
=0.04). In reclassification analyses, adding NephroCheck to the ED score improved the prediction of AKI development (
<0.05). The T0 NephroCheck value predicted 30-day mortality (AUC, 0.68;
<0.001).
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. |
|---|---|
| AbstractList | 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.
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.
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)
/1,000, P=0.001), and better predicted AKI development than the ED score (area under the curve [AUC], 0.64 vs. 0.53;
=0.04). In reclassification analyses, adding NephroCheck to the ED score improved the prediction of AKI development (
<0.05). The T0 NephroCheck value predicted 30-day mortality (AUC, 0.68;
<0.001).
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. 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. KCI Citation Count: 0 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.BackgroundUrine 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.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.MethodsThis 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.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).ResultsAmong 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).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.ConclusionsNephroCheck 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. |
| Author | Kim, Hahn Young Werayachankul, Thiyapha Endre, Zoltan Hur, Mina Herath, Sanjeeva Phattharapornjaroen, Phatthranit Di Somma, Salvatore Anandh, Urmila Kitiyakara, Chagriya Antonini, Paola Kuan, Win Sen Chua, Mui Teng Yang, Hyun Suk Lee, Kyeong Ryong Horvath, Andrea Rita Chittamma, Anchalee Kim, Hanah Chua, Horng Ruey Kim, Jong Won |
| AuthorAffiliation | 5 Department of Emergency Medicine, Division of Nephrology, National University Hospital, National University Health System, Singapore 16 Department of Medical-Surgery Sciences and Translational Medicine, University of Rome La Sapienza, Rome, Italy 4 Departments of Neurology, Konkuk University School of Medicine, Seoul, Korea 12 Department of Nephrology, Yashoda Hospital, Secunderabad, India 1 Departments of Cardiovascular Medicine, Konkuk University School of Medicine, Seoul, Korea 14 New South Wales Health Pathology, Department of Chemical Pathology, Prince of Wales Hospital, Sydney, Australia 7 Departments of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand 15 GREAT Network Italy, University of Rome La Sapienza, Rome, Italy 6 Department of Medicine, National University Hospital, National University Health System, Singapore 3 Departments of Emergency Medicine, Konkuk University School of Medicine, Seoul, Korea 11 Section of Pharmaceutical Care, Faculty |
| AuthorAffiliation_xml | – name: 15 GREAT Network Italy, University of Rome La Sapienza, Rome, Italy – name: 13 Department of Nephrology, Prince of Wales Hospital, Sydney, Australia – name: 2 Departments of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea – name: 10 Section of Translational Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand – name: 4 Departments of Neurology, Konkuk University School of Medicine, Seoul, Korea – name: 12 Department of Nephrology, Yashoda Hospital, Secunderabad, India – name: 1 Departments of Cardiovascular Medicine, Konkuk University School of Medicine, Seoul, Korea – name: 3 Departments of Emergency Medicine, Konkuk University School of Medicine, Seoul, Korea – name: 14 New South Wales Health Pathology, Department of Chemical Pathology, Prince of Wales Hospital, Sydney, Australia – name: 16 Department of Medical-Surgery Sciences and Translational Medicine, University of Rome La Sapienza, Rome, Italy – name: 6 Department of Medicine, National University Hospital, National University Health System, Singapore – name: 8 Departments of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand – name: 11 Section of Pharmaceutical Care, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, Thailand – name: 9 Departments of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand – name: 5 Department of Emergency Medicine, Division of Nephrology, National University Hospital, National University Health System, Singapore – name: 7 Departments of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand |
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| Cites_doi | 10.1515/cclm-2018-0776 10.1093/ndt/gfy186 10.1159/000349963 10.1186/cc12484 10.1681/ASN.2018030265 10.7326/0003-4819-150-9-200905050-00006 10.1177/0004563220970032 10.1007/s00134-016-4670-3 10.1053/j.ajkd.2015.12.033 10.1186/cc11240 10.1007/s00134-015-3934-7 10.1093/ije/dyz274 10.1186/cc5713 10.1002/sim.2929 10.1186/cc12510 10.1002/clc.22683 10.1053/j.ajkd.2013.02.349 10.1164/rccm.201401-0077OC 10.1161/01.CIR.0000025242.79963.4C 10.1093/jalm/jfab020 10.1097/SLA.0000000000002485 10.1038/s41598-020-63315-x 10.1097/01.ASN.0000059863.48590.E9 10.1186/cc2872 10.2215/CJN.02430315 10.1152/ajprenal.00448.2010 10.1038/nrneph.2017.2 10.1186/cc12503 10.3343/alm.2021.41.1.1 10.1038/ki.2014.328 10.1515/cclm-2012-0433 10.2215/CJN.10551015 10.2215/CJN.00710113 |
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| SubjectTerms | Acute Disease Acute Kidney Injury - diagnosis Aged Biomarkers Emergency Service, Hospital Female Humans Insulin-Like Growth Factor Binding Proteins - urine Male Original Prospective Studies Tissue Inhibitor of Metalloproteinase-2 - urine United States 병리학 |
| 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 |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/34635611 https://www.proquest.com/docview/2581287994 https://pubmed.ncbi.nlm.nih.gov/PMC8548247 https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002811253 |
| Volume | 42 |
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| ispartofPNX | Annals of Laboratory Medicine, 2022, 42(2), , pp.178-187 |
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