Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, University Hospital Münster, Münster, Germany.
Department of Critical Care, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom.
Crit Care Med. 2023 Aug 1;51(8):992-1000. doi: 10.1097/CCM.0000000000005853. Epub 2023 Mar 28.
Patients with COVID-19-associated acute respiratory distress syndrome (ARDS) have a high risk for developing acute kidney injury (AKI) which is associated with an increased risk of death and persistent renal failure. Early prediction of AKI is crucial in order to implement preventive strategies. The purpose of this study was to investigate the predictive performance of tissue inhibitor of metalloproteinases 2 and insulin like growth factor binding protein 7 (TIMP-2) × (IGFBP7) in critically ill patients with COVID-19-associated ARDS.
Multicenter, prospective, observational study.
Twelve centers across Europe and United Kingdom.
Patients with moderate or severe COVID-19-associated ARDS were included and serial measurements of (TIMP-2) × (IGFBP7) were performed.
None.
The primary endpoint was the development of moderate or severe AKI according to the Kidney Disease: Improving Global Outcomes definition. Three hundred patients were available for the primary analysis, and 39 met the primary endpoint. At enrollment, urinary (TIMP-2) × (IGFBP7) had high predictive value for the primary endpoint with an area under the receiver operating characteristic curve of 0.89 (95% CI, 0.84-0.93). (TIMP-2) × (IGFBP7) was significantly higher in endpoint-positive patients at enrollment and at 12 hours.
Urinary (TIMP-2) × (IGFBP7) predicts the occurrence of AKI in critically ill patients with COVID-19-associated ARDS.
COVID-19 相关急性呼吸窘迫综合征（ARDS）患者发生急性肾损伤（AKI）的风险较高，而 AKI 与死亡率增加和持续性肾衰竭有关。早期预测 AKI 对于实施预防策略至关重要。本研究旨在探讨组织金属蛋白酶抑制剂 2 和胰岛素样生长因子结合蛋白 7（TIMP-2）×（IGFBP7）在 COVID-19 相关 ARDS 危重症患者中的预测性能。
多中心、前瞻性、观察性研究。
欧洲和英国的 12 个中心。
纳入中度或重度 COVID-19 相关 ARDS 患者，并进行（TIMP-2）×（IGFBP7）的连续测量。
无。
主要终点是根据肾脏病：改善全球结局（KDIGO）定义发生中度或重度 AKI。300 例患者可进行主要分析，其中 39 例符合主要终点。在入组时，尿（TIMP-2）×（IGFBP7）对主要终点具有较高的预测价值，受试者工作特征曲线下面积为 0.89（95%CI，0.84-0.93）。在入组时和 12 小时时，终点阳性患者的尿（TIMP-2）×（IGFBP7）明显更高。
尿（TIMP-2）×（IGFBP7）可预测 COVID-19 相关 ARDS 危重症患者 AKI 的发生。
