Mechanism and clinical role of TIMP-2 and IGFBP-7 in cardiac surgery-associated acute kidney injury: A review

• Published in: Medicine (Baltimore) Vol. 103; no. 21; p. e38124
• Main Authors: Leng, Jiajie, Li, Letai, Tu, Hongwen, Luo, Yuxiang, Cao, Zhenrui, Zhou, Kun, Rizvi, Syed M Musa, Tie, Hongtao, Jiang, Yingjiu
• Format: Journal Article
• Language: English
• Published: United States 24.05.2024
• Subjects: Acute Kidney Injury - blood; Acute Kidney Injury - diagnosis; Acute Kidney Injury - etiology; Biomarkers - blood; Cardiac Surgical Procedures - adverse effects; Humans; Insulin-Like Growth Factor Binding Proteins - blood; Insulin-Like Growth Factor Binding Proteins - urine; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Prognosis; Tissue Inhibitor of Metalloproteinase-2 - blood; Tissue Inhibitor of Metalloproteinase-2 - urine
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000038124

Acute kidney injury (AKI) is a common postoperative complication, but there is still a lack of accurate biomarkers. Cardiac surgery-associated AKI is the most common cause of major-surgery-related AKI, and patients requiring renal replacement therapy have high mortality rates. Early diagnosis, intervention, and management are crucial for improving patient prognosis. However, diagnosing AKI based solely on changes in serum creatinine level and urine output is insufficient, as these changes often lag behind actual kidney damage, making early detection challenging. Biomarkers such as tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein-7 (IGFBP-7) have been found to be significant predictors of moderate-to-severe AKI when combined with urine content analysis. This article reviews the mechanism of biomarkers TIMP-2 and IGFBP-7 in AKI and provides a comprehensive overview of the clinical effects of TIMP-2 and IGFBP-7 in cardiac surgery-associated AKI, including prediction, diagnosis, and progression.