Newly published findings suggest that certain urinary biomarkers could help clinicians identify risk of acute kidney injury in patients with acute decompensated heart failure. The study, published in Clinical Cardiology, is the first to investigate the risk assessment capabilities of TIMP-2 and IGFBP7, the urinary biomarkers measured by the test, in emergency department patients with acute decompensated heart failure.
“Among hospitalised patients, approximately 25% have evidence of acute kidney injury, which defines them as Type 1 cardiorenal syndrome patients,” says Peter A McCullough, president of the Cardio Renal Society of America (CRSA). “These patients are often diagnosed late and have increased lengths of stay, rehospitalisations, and mortality.”
The study, conducted at Robert Bosch Hospital in Stuttgart, Germany, enrolled patients during initial workup in the emergency department. The investigators found that [TIMP-2] x [IGFBP7] measurements identified acute decompensated heart failure patients at risk of developing moderate to severe (stage two to three) acute kidney injury for samples collected within 24 hours of enrolment. The authors also reported an area under the curve of 0.84 (95% CI: 0.72-0.93), a sensitivity of 86% at a 0.3 cut-off and specificity of 95% at the 2 cut-off for prediction of acute kidney injury stage two to three.
“Physicians are looking forward to the widespread use of a test that can detect acute kidney injury long before the rise of serum creatinine and allow doctors an opportunity to adjust medications and provide more effective therapy for this important patient population,” says McCullough.