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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.<jats:italic>Methods<\/jats:italic>. 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).<jats:italic>Results<\/jats:italic>. A level of<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mtext>uMMP<\/mml:mtext><mml:mo>\u2010<\/mml:mo><mml:mn>7<\/mml:mn><mml:mo>&gt;<\/mml:mo><mml:mn>7.8<\/mml:mn><mml:mtext>\u2009<\/mml:mtext><mml:mi>\u03bc<\/mml:mi><mml:mtext>g<\/mml:mtext><mml:mo>\/<\/mml:mo><mml:mtext>g<\/mml:mtext><mml:mtext>\u2009<\/mml:mtext><mml:mtext>Cr<\/mml:mtext><\/mml:math>at time of AKI diagnosis conveyed an 8-fold risk of AKI progression as compared to those with<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mtext>uMMP<\/mml:mtext><mml:mo>\u2010<\/mml:mo><mml:mn>7<\/mml:mn><mml:mo>&lt;<\/mml:mo><mml:mn>2.7<\/mml:mn><mml:mtext>\u2009<\/mml:mtext><mml:mi>\u03bc<\/mml:mi><mml:mtext>g<\/mml:mtext><mml:mo>\/<\/mml:mo><mml:mtext>g<\/mml:mtext><\/mml:math>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.<jats:italic>Conclusions<\/jats:italic>. 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.<\/jats:p>","DOI":"10.1155\/2019\/9217571","type":"journal-article","created":{"date-parts":[[2019,11,19]],"date-time":"2019-11-19T18:30:38Z","timestamp":1574188238000},"page":"1-7","source":"Crossref","is-referenced-by-count":19,"title":["Urinary Matrix Metalloproteinase-7 and Prediction of AKI Progression Post Cardiac Surgery"],"prefix":"10.1155","volume":"2019","author":[{"given":"Fan","family":"Fang","sequence":"first","affiliation":[{"name":"Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Institute, Guangzhou, China"},{"name":"Department of Nephrology, Zhongshan Hospital, Xiamen University, Xiamen, 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