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dc.contributor.authorSelby, Nicholas
dc.date.accessioned2018-07-09T11:27:24Z
dc.date.available2018-07-09T11:27:24Z
dc.date.issued2018-06
dc.identifier.citationBiomarkers. 2018 Jun 26:1-21. doi: 10.1080/1354750X.2018.1493617. [Epub ahead of print]en
dc.identifier.urihttp://hdl.handle.net/20.500.12904/787
dc.descriptionAuthor(s) Pre or Post Print Version Onlyen
dc.description.abstractINTRODUCTION: Early recognition of patients developing acute kidney injury is of considerable interest, we report the first use of a combination of a clinical prediction rule with a biomarker in emergent adult medical patients to improve AKI recognition. METHODS: Single-centre prospective pilot study of medical admissions without AKI identified as high risk by a clinical prediction rule. Urine samples were obtained and tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) - biomarkers associated with cell cycle arrest, were measured. OUTCOME: Creatinine based KDIGO hospital-acquired AKI (HA-AKI). RESULTS: Of 69 patients recruited, HA-AKI developed in 13% (n = 9), in whom biomarker values were higher (median 0.43 [interquartile range 0.21-1.25] vs. 0.07 [0.03-0.16] in cases without (P = 0.008). Peak rise in creatinine was higher in biomarker positive cases (median 30 μmol/l (7-72) vs 1 μmol/l (0-16), P = 0.002). AUROC was 0.78 (95% CI 0.57-0.98). At the suggested cut-off (0.3) sensitivity for predicting AKI was 78% (95% CI 40-97%), specificity 89% (78-95%), positive predictive value 50% (31-69%) and negative predictive value 96% (89-99%). DISCUSSION: Addition of a urinary biomarker allows exclusion of a significant number of patients identified to be at higher risk of AKI by a clinical prediction rule.en
dc.language.isoenen
dc.subjectAcute Kidney Injuryen
dc.subjectAKIen
dc.subjectInsulin-Like Growth Factor Binding Protein 7en
dc.subjectIGFBP7en
dc.subjectTissue Inhibitor of Metalloproteinases-2en
dc.subjectTIMP-2en
dc.titleImproving Clinical Prediction Rules In Acute Kidney Injury With The Use of Biomarkers of Cell Cycle Arrest: A Pilot Study.en
dc.typeArticleen


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