{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:26:31Z","timestamp":1787243191237,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Identifying a panel of markers detecting kidney injury before the glomerular filtration rate reduction is a challenge to improving the diagnosis and management of acute kidney injury (AKI) in septic patients. This study evaluated the roles of tissue inhibitor metal proteinase-2, insulin growth factor binding protein-7 (TIMP2*IGFBP7), and mid-regional pro-adrenomedullin (MR-proADM) in patients with AKI. Patients and Methods: This study was prospectively conducted in an intensive care unit (ICU) enrolling 230 patients who underwent cardiac surgery. Biomarkers were evaluated before and after 4 h of the cardiac surgery. Results: Whereas urine and creatinine alterations appeared at 23.2 (12.7\u201336.5) hours after cardiac surgery, urinary TIMP2*IGBP7 levels were higher at 4 h in AKI patients (1.1 \u00b1 0.4 mg\/L vs. 0.08 \u00b1 0.02 mg\/L; p &lt; 0.001). Its concentration &gt; 2 mg\/L increases AKI risk within the following 24 h, clearly identifying the population at high risk of renal replacement therapy (RRT). In patients with sepsis, MR-proADM levels were 2.3 nmol\/L (0.7\u20137.8 nmol\/L), with the highest values observed in septic shock patients (5.6 nmol\/L (3.2\u201318 nmol\/L)) and a better diagnostic profile than procalcitonin and C-reactive protein to identify septic patients. MR-proADM values &gt; 5.1 nmol\/L and urine TIMP2*IGBP7 levels &gt; 2 mg\/L showed a significantly faster progression to RRT, with a mean follow-up time of 1.1 days. Conclusions: TIMP2*IGBP7 and MR-proADM precociously diagnose AKI in septic patients after cardiac surgery, giving prognostic information for RRT requirement.<\/jats:p>","DOI":"10.3390\/jcm12165193","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T10:21:50Z","timestamp":1691576510000},"page":"5193","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Acute Kidney Injury and Sepsis after Cardiac Surgery: The Roles of Tissue Inhibitor Metalloproteinase-2, Insulin-like Growth Factor Binding Protein-7, and Mid-Regional Pro-Adrenomedullin"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1705-8770","authenticated-orcid":false,"given":"Antonio","family":"Lacquaniti","sequence":"first","affiliation":[{"name":"Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1286-0505","authenticated-orcid":false,"given":"Fabrizio","family":"Ceresa","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Campo","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Barbera","sequence":"additional","affiliation":[{"name":"Clinical Pathology Unit, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Caruso","sequence":"additional","affiliation":[{"name":"Clinical Pathology Unit, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elenia","family":"Palazzo","sequence":"additional","affiliation":[{"name":"Clinical Pathology Unit, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5023-6247","authenticated-orcid":false,"given":"Francesco","family":"Patan\u00e8","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0492-5022","authenticated-orcid":false,"given":"Paolo","family":"Monardo","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1001\/jama.294.7.813","article-title":"Acute renal failure in critically ill patients: A multinational, multicenter study","volume":"294","author":"Uchino","year":"2005","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"371","DOI":"10.3109\/1354750X.2016.1141991","article-title":"Delayed graft function and chronic allograft nephropathy: Diagnostic and prognostic role of neutrophil gelatinase-associated lipocalin","volume":"21","author":"Lacquaniti","year":"2016","journal-title":"Biomarkers"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/j.1440-1797.2009.01163.x","article-title":"Neutrophil gelatinase-associated lipocalin levels in chronic haemodialysis patients","volume":"15","author":"Bolignano","year":"2010","journal-title":"Nephrology"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Tao, X., Chen, C., Luo, W., Zhou, J., Tian, J., Yang, X., and Hou, F.F. 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