Yang H.S.Hur M.Lee K.R.Kim H.Kim H.Y.Kim J.W.Chua M.T.Kuan W.S.Chua H.R.Kitiyakara C.Phattharapornjaroen P.Chittamma A.Werayachankul T.Anandh U.Herath S.Endre Z.Horvath A.R.Antonini P.Somma S.D.Mahidol University2023-06-182023-06-182022-01-01Annals of Laboratory Medicine Vol.42 No.2 (2022) , 178-18722343806https://repository.li.mahidol.ac.th/handle/20.500.14594/83948Background: 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.Biochemistry, Genetics and Molecular BiologyBiomarker 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/igfbp7ArticleSCOPUS10.3343/alm.2022.42.2.1782-s2.0-851182756812234381434635611