Diagnostic Efficiency and Prognosis of Urinary TIMP-2 and KIM-1 in Patients with Sepsis Complicated with Acute Kidney Injury
WANG Xia
CHEN Hui
ZHAO Kun
LI Xuan
LIU Fang
HE Lili
Abstract：Objective To investigate the diagnostic efficacy of urinary tissue inhibitor of metalloproteinase-2(TIMP-2)and kidney injury molecule-1(KIM-1)for sepsis complicated with acute kidney injury(AKI)and their relationship with prognosis.Methods A total of 116 sepsis patients admitted to the Second Hospital of Hebei Medical University from January 2023 to January 2024 were selected and divided into the AKI group(39 patients)and the non-AKI group(77 patients)based on AKI occurrence.Urine samples were collected from all patients at admission for TIMP-2 and KIM-1 detection.The AKI group was further subdivided into a survival group(22 patients)and a death group(17 patients)according to 28-day survival.Receiver operating characteristic(ROC)curves were used to analyze the diagnostic value of urinary TIMP-2 and KIM-1 for sepsis complicated with AKI,and multivariate logistic regression was used to identify prognostic factors.Results Urinary TIMP-2 and KIM-1 levels were higher in the AKI group than in the non-AKI group(all P<0.05).The areas under the curve(AUC)(95%CI)of urinary TIMP-2 and KIM-1 for predicting sepsis complicated with AKI were 0.817(0.772-0.862)and 0.749(0.699-0.794),respectively,while the combined AUC(95%CI)was 0.923(0.878-0.968).Urinary TIMP-2 and KIM-1 levels were higher in the death group than in the survival group(all P<0.05).No significant differences existed in gender,age,BMI,hemoglobin,albumin,serum potassium,AKI stage,comorbidities,smoking history,or alcohol history between groups(all P>0.05).The death group had higher white blood cell counts,serum phosphorus,APACHE Ⅱ scores,SOFA scores,and mechanical ventilation rates(all P<0.05).Multivariate analysis showed that APACHE Ⅱ score≥26.2(OR=2.136,95%CI:1.263-3.612),SOFA score≥12.04(OR=2.469,95%CI:1.203-5.070),urinary TIMP-2≥27.59 ng/mL(OR=4.468,95%CI:2.060-9.691),and urinary KIM-1≥7.12 ng/mL(OR=3.777,95%CI:1.808-7.893)were independent prognostic factors for sepsis complicated with AKI patients(all P<0.05).Conclusion Urinary TIMP-2 and KIM-1 are highly expressed in sepsis complicated with AKI,and their combination demonstrates high diagnostic value.Both biomarkers are closely associated with the prognosis of sepsis complicated with AKI patients.
Keywords：sepsisacute kidney injurymetalloproteinase inhibitor-2kidney damage molecule-1diagnostic effectivenessprognosis
Publication Date：2025-08-20
Online Publishing Date：2025-09-18(First online date of this platform, not the publication date of the document)
Pages：6( 1-6 )