Predictive values of urinary metalloproteinases-2 and insulin-like growth factor-binding protein 7 for contrast medium-induced acute kidney injury
ObjectiveTo explore the expressions of tissue inhibitor of metalloproteinases-2 （TIMP-2） and insulin-like growth factor-binding protein 7 （IGFBP7） in renal tissue and urine after an injury of contrast medium （CM） and the prediction values of urinary TIMP-2 and IGFBP7 for contrast-induced acute kidne...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Department of Journal of Clinical Nephrology
2022-03-01
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| Series: | Linchuang shenzangbing zazhi |
| Subjects: | |
| Online Access: | http://www.lcszb.com/thesisDetails#10.3969/j.issn.1671-2390.2022.03.008 |
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| Summary: | ObjectiveTo explore the expressions of tissue inhibitor of metalloproteinases-2 （TIMP-2） and insulin-like growth factor-binding protein 7 （IGFBP7） in renal tissue and urine after an injury of contrast medium （CM） and the prediction values of urinary TIMP-2 and IGFBP7 for contrast-induced acute kidney injury （CI-AKI） in patients with primary percutaneous coronary intervention （PPCI）.MethodsTwenty male Sprague-Dawley rats were divided randomly into two groups of CI-AKI （<italic>n</italic>=9） and control （<italic>n</italic>=11）. Serum creatinine （Scr） level was measured before an injection of CM or normal saline （NS） and at 24h post-intervention. Kidney samples，containing both cortex and medulla，were harvested for hematoxylin-eosin （HE） staining and immunohistochemistry. Urinary samples for TIMP-2 and IGFBP7 were collected at 4/12/24 h post-injection. From January 2019 to December 2020，116 patients undergoing PPCI were recruited. Baseline profiles and laboratory findings were recorded. Receiver operating curves （ROC） of urinary TIMP-2/IGFBP7 concentrations at 6 h post-CI-AKI were evaluated for the possibility of serving as potential biomarkers in early prediction of CI-AKI.ResultsAs compared with control group，the average elevation of Scr was over baseline in CI-AKI group （<italic>P</italic><0.05）. CM intervention induced marked histopathological changes in kidney tissue，including vacuole-like denaturation，nucleus pyknosis and apoptotic body formation. The mean Paller score was significantly higher in CI-AKI group. A robust formation of autophagosome was observed with transmission electron microscope in CI-AKI group. Rising significantly and peaking at 4 h after CM injection，urinary levels of TIMP-2 were higher than those in controls at the same observation timepoints （<italic>P</italic><0.05）. Urinary IGFBP7 levels were markedly up-regulated at 4 h after CM injection and peaked within 12 h. And the values were higher than those in controls at the same observation timepoints （<italic>P</italic><0.05）. The expression of TIMP-2/IGFBP7 was significantly elevated in renal tubular epithelial cells after CM injury. CI-AKI occurred in 16/109 patients with an incidence of 20.8%. As comparing with control group，urinary level of TIMP-2/IGFBP7 of CI-AKI group was significantly elevated at 6 h post-operation（<italic>P</italic><0.05）. For an onset of CI-AKI after PPCI，PLR had an area under the curve （AUC） value of 0.841 on ROC. For a cutoff value of 0.33，urinary TIMP-2/IGFBP7 had a sensitivity of 75.0% and a specificity of 89.3% for predicting CI-AKI.ConclusionThe expressions of TIMP-2 and IGFBP7 are markedly up-regulated in proximal tubular epithelial cells and urine after CM injury. Urinary level of TIMP-2/IGFBP7 is an early predictor of CI-AKI in PPCI patients. |
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| ISSN: | 1671-2390 |