Urinary Matrix Metalloproteinase-7 and Prediction of AKI Progression Post Cardiac Surgery

الملخص EN

Aims.

Early detection of patients at high risk for progressive acute kidney injury (AKI) after cardiac surgery remains a major challenge.

We aim to evaluate the utility of urinary matrix metalloproteinase-7 (uMMP-7) and other reported biomarkers for predicting AKI progression during postoperative hospital stay.

Methods.

We conducted a prospective, multicenter cohort study in 121 adult patients with stage 1 or 2 AKI after cardiac surgery.

uMMP-7 and other well-reported biomarkers (uIL-18, uNGAL, and UACR) were measured at time of AKI clinical diagnosis.

The primary outcome is the progression of AKI after cardiac surgery, defined as worsening of AKI stage (stage 1 to either stage 2 or stage 3 or from stage 2 to stage 3).

Results.

A level of uMMP‐7>7.8 μg/g Cr at time of AKI diagnosis conveyed an 8-fold risk of AKI progression as compared to those with uMMP‐7<2.7 μg/g after adjusting for clinical risk factors.

The performance of uMMP-7 for predicting progressive AKI was good with an AUC of 0.80.

The combination of uMMP-7 and IL-18 produces the greatest AUC for predicting progressive AKI.

Addition of uMMP-7 to the clinical risk factor model significantly improved risk reclassification for AKI progression.

Conclusions.

uMMP-7, measured at time of AKI clinical diagnosis, is a novel biomarker for predicting the progression of AKI after cardiac surgery.

Adding uMMP-7 to the clinical risk factor model may be used as a noninvasive approach to identify a subpopulation that is at high risk for progressive AKI after cardiac surgery.