腹部大手术中的急性术后肾脏损伤。尿液生物标志物[TIMP-2] × [IGFBP7] （NephroCheck®）的效用

IF 0.8 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-05-23 DOI:10.1016/j.redar.2025.501853

A. Lara-Jiménez , P. Monedero , G. Echarri

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引用次数: 0

摘要

尿生物标志物[TIMP-2] × [IGFBP7]能够预测术后急性肾损伤（PO-AKI）。本研究旨在评估接受腹部大手术的高危患者PO-AKI的发生率，并评估实施KDIGO肾脏优化措施对[TIMP-2] × [IGFBP7]识别的肾应激患者的影响。材料和方法这是一项前瞻性研究，包括182例接受腹部大手术的患者。收集围手术期数据、[TIMP-2] × [IGFBP7]水平及KDIGO肾保护策略在ICU的实施情况。通过多变量分析确定PO-AKI的预测因素。结果PO-AKI总发生率为25.3%，ICU患者发生率为42.7%。[TIMP-2] × [IGFBP7]具有中等预测能力（AUROC = .74），升高的患者PO-AKI发生率为47.5%。尽管在ICU实施了KDIGO措施，但在[TIMP-2] × [IGFBP7]升高的患者中，PO-AKI的发生率为65.6%。在多因素分析中，PO-AKI的主要预测因子为[TIMP-2] × [IGFBP7]升高(OR = 6.3；95% ci: 2.6-15.6；P & lt;.001)，男性(OR = 6.1；95% ci: 1.9-19.6；P = .002)， ICU住院率(OR = 4.5；95% ci: 1.5-13.6；p = .009)。结论spoo - aki在腹部大手术后较为常见，尤其是在ICU患者中。[TIMP-2] × [IGFBP7]生物标志物允许早期识别高危患者，尽管在ICU实施KDIGO措施并没有显著降低其发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Lesión renal aguda postoperatoria en cirugía mayor abdominal. Utilidad del biomarcador urinario [TIMP-2] × [IGFBP7] (NephroCheck®)

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Lesión renal aguda postoperatoria en cirugía mayor abdominal. Utilidad del biomarcador urinario [TIMP-2] × [IGFBP7] (NephroCheck®)

Background

The urinary biomarker [TIMP-2] × [IGFBP7] enables the prediction of postoperative acute kidney injury (PO-AKI). Our study aimed to assess the incidence of PO-AKI in high-risk patients undergoing major abdominal surgery and to evaluate the impact of implementing KDIGO renal optimization measures in those with renal stress identified by [TIMP-2] × [IGFBP7].

Materials and methods

This was a prospective study including 182 patients who underwent major abdominal surgery. Perioperative data, [TIMP-2] × [IGFBP7] levels, and the implementation of KDIGO renal protection strategies in the ICU were collected. Predictors of PO-AKI were identified through multivariate analysis.

Results

The overall incidence of PO-AKI was 25.3%, reaching 42.7% in ICU patients. [TIMP-2] × [IGFBP7] showed moderate predictive ability (AUROC = .74), with a PO-AKI incidence of 47.5% in patients with elevated levels. Despite the implementation of KDIGO measures in the ICU, the incidence of PO-AKI in patients with elevated [TIMP-2] × [IGFBP7] was 65.6%. In multivariate analysis, the main predictors of PO-AKI were elevated [TIMP-2] × [IGFBP7] (OR = 6.3; 95% CI: 2.6-15.6; P < .001), male sex (OR = 6.1; 95% CI: 1.9-19.6; P = .002), and ICU admission (OR = 4.5; 95% CI: 1.5-13.6; P = .009).

Conclusions

PO-AKI is common after major abdominal surgery, particularly in ICU patients. The [TIMP-2] × [IGFBP7] biomarker allows for early identification of at-risk patients, although the implementation of KDIGO measures in the ICU did not significantly reduce its incidence.

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