Validation of the Cell Cycle Arrest Biomarkers in the Diagnosis of
Pregnancy Related Acute Kidney Injury
Background: Pregnancy related acute kidney injury (PRAKI) is still a
common serious problem in developing countries. Insulin-like growth
factor-binding protein 7 (IGFBP7) and tissue inhibitor
metalloproteinases-2 (TIMP-2) can identify critically ill patients at
risk for the development of severe AKI. Objectives: To identify main
causes and timing of PRAKI and to study the G1 cell cycle arrest
biomarkers in cases diagnosed with (PRAKI) as a diagnostic tool.
Methods: 80 pregnant women diagnosed with PRAKI were recruited from a
single hospital as well as 30 age-matched pregnant women with normal
pregnancy participated in this study. A urine specimen was collected
from all study participants with established AKI within 24 hours of ICU
admission to measure IGFBP7*TIMP-2. Results: The incidence of PRAKI was
1.1%. The most common cause of PRAKI is preeclampsia/eclampsia spectrum
(61%). Most of the cases occur in the third trimester (60%) and
postpartum period (23%). At a cutoff 0.33 ng/mL, the estimated
sensitivity and specificity of urinary [TIMP-2]*[IGFBP7] in
predicting PRAKI is 100% (95% CI) with NPV and PPV are 100%.
Conclusions: Urinary [TIMP-2]*[IGFBP7] serves as a sensitive and
specific biomarker in the diagnosis of PRAKI.