Urinary NGAL showed high diagnostic value for predicting cardiac surgery-associated AKI in children (AUROC > 0.8 in 7 of 9 studies), while TIMP-2 and IGFBP7 showed high value in adults.
Systematic Review
Do urinary biomarkers (NGAL, TIMP-2, IGFBP7) serve as early predictors of cardiac surgery-associated AKI in patients undergoing cardiac surgery?
Urinary NGAL is a strong predictor of cardiac surgery-associated AKI in children, while TIMP-2 and IGFBP7 are highly predictive in adults.
Introduction: Acute kidney injury following cardiac surgery is a dreaded complication contributing to early mortality. Diagnosing AKI using serum creatinine usually results in a delay. To combat this, certain kidney damage specific biomarkers were investigated to identify if they can serve as early predictors of cardiac surgery-associated AKI (CSA-AKI). This study systematically reviews three such biomarkers; NGAL, tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein-7 (IGFBP7) to identify if they can serve as early predictors of CSA-AKI.Methods: Systematic search was carried out on literature reporting the diagnostic ability of the three biomarkers from databases in accordance with PRISMA guidelines.Results: We found 43 articles reporting urinary-NGAL levels (n = 34 in adults, n = 9 in children) and 10 studies reporting TIMP-2 and IGFBP7 levels among adults. Interestingly, NGAL showed high diagnostic value in predicting AKI in children (seven among nine studies with AUROC > 0.8). The cell cycle arrest biomarkers, namely TIMP-2 and IGFBP7, showed high diagnostic value in predicting AKI in adults (five among ten studies with AUROC > 0.8).Conclusion: In predicting CSA-AKI; the diagnostic value of NGAL is high in the paediatric population while the diagnostic value of TIMP-2 and IGFBP7 is high in adults.
Hussain et al. (Mon,) conducted a systematic review in Cardiac surgery-associated acute kidney injury (CSA-AKI). Urinary biomarkers (NGAL, TIMP-2, IGFBP7) was evaluated on Diagnostic value in predicting AKI. Urinary NGAL showed high diagnostic value for predicting cardiac surgery-associated AKI in children (AUROC > 0.8 in 7 of 9 studies), while TIMP-2 and IGFBP7 showed high value in adults.