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Clin Chim Acta. 2016 Jan 15;452:32-7. doi: 10.1016/j.cca.2015.10.029. Epub 2015 Nov 10.

Reference intervals of urinary acute kidney injury (AKI) markers [IGFBP7]∙[TIMP2] in apparently healthy subjects and chronic comorbid subjects without AKI.

Author information

1
Department of Pathology, Center for Advanced Laboratory Medicine, University of California-San Diego Health Systems, San Diego, CA, United States.
2
Department of Anesthesiology and Critical Care Medicine, George Washington University Medical Center, Washington, DC, United States.
3
Department of Pathology and ARUP Laboratories, University of Utah School of Medicine, Salt Lake City, UT, United States.
4
Department of Pathology, University of Louisville, Louisville, KY, United States.
5
John T. Mather Memorial Hospital, Port Jefferson, NY, United States.
6
Phoenix Medical Group, Peoria, AZ, United States.
7
Center for Critical Care Nephrology Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
8
Department of Pathology, Center for Advanced Laboratory Medicine, University of California-San Diego Health Systems, San Diego, CA, United States. Electronic address: rfitzgerald@ucsd.edu.

Abstract

BACKGROUND:

Insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases-2 (TIMP-2) have demonstrated significantly improved diagnostic performance in assessing risk for acute kidney injury (AKI) compared with existing biomarkers. We present the findings of a multi-site trial to determine the reference intervals for these biomarkers in apparently healthy adults and those with stable chronic morbid conditions without AKI.

METHODS:

A urine specimen was collected from apparently healthy subjects (N=378) and subjects with at least one stable chronic morbidity (N=372). Specimens were kept frozen until analysis with the NephroCheck® Test (Astute Medical). The test is comprised of fluorescence immunoassays for IGFBP7 and TIMP-2 and is used with the Astute140® Meter which quantifies the concentration of each biomarker. The meter multiplies the concentrations of IGFBP7 and TIMP-2 and displays the result as a numerical value ([IGFBP7]∙[TIMP-2]) expressed in (ng/ml)(2)/1000 which is called the AKIRisk™ Score.

RESULTS:

The reference intervals (inner 95%) for [IGFBP7]∙[TIMP-2] in all subjects (N=750), apparently healthy subjects, and subjects with stable chronic morbidities were 0.04-2.22, 0.04-2.25, and 0.05-2.20 (ng/ml)(2)/1000 respectively. There was no statistical difference between reference intervals for apparently healthy and chronic stable morbid cohorts (p=0.42).

CONCLUSIONS:

Our investigation showed that urine [IGFBP7]∙[TIMP-2] values were not elevated in patients with stable chronic morbidities who did not have AKI.

KEYWORDS:

Acute kidney injury; Cell-cycle arrest; Insulin-like growth factor-binding protein 7 (IGFBP7); Nephrocheck; Reference interval; Tissue inhibitor of metalloproteinases-2 (TIMP-2)

PMID:
26522657
DOI:
10.1016/j.cca.2015.10.029
[Indexed for MEDLINE]
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