Urinary Tissue Inhibitor of Metalloproteinase-2 as Early Predictor for Acute Kidney Injury in Critically Ill Children

Abstract

ritically ill children are at increased risk of developing acute kidney injury (AKI). AKI is associated with a variety of short term and long term kidney impairment as well as high incidence of morbidity and mortality in the intensive care unit (McCaffrey et al., 2015). Changes in the serum creatinine levels (SCr) is considered one of the most important diagnostic and staging criteria for AKI. However, SCr is considered a late, unspecific marker of decreased glomerular filtration rate and is also insensitive to the acute changes that occur in the renal functions (Kellum et al., 2016; Westhoff et al., 2015). Recently, many studies reported the discovery and validation of G1 cell cycle arrest biomarkers in urine for early diagnosis of kidney affection. These biomarkers include tissue inhibitor of metalloproteinase-2 (TIMP-2) (Bihorac et al., 2014; Hoste et al., 2014; Kashani et al., 2013). On the other hand, nutritional assessment is an essential tool for the evaluation and monitoring of patients who have acute kidney injury (AKI). Some studies have proved the correlation between some nutritional biomarkers and the clinical outcome in patients with AKI. The use markers like albumin, cholesterol and IGF-1 appears to be a useful screeni