A prospective diagnostic study investigating urinary biomarkers of acute kidney injury (AKI) in major abdominal surgery (the AKI-biomas study)
Authors' conclusion
NGAL and IGFBP-7*TIMP-2 showed reasonable diagnostic performance when diagnosing AKI by serum creatinine criteria, with NGAL returning the highest AUC values.
Study context
- Population
- Patients undergoing major abdominal surgery
- Participants
- 488 patients
- Comparison
- Urinary NGAL, KIM-1, DKK-3 and IGFBP-7*TIMP-2 at 4 h post-surgery for predicting post-operative AKI
- Outcome
- Diagnostic performance (ROC AUC) for post-operative AKI by serum creatinine and urine output criteria
- Follow-up
- Urine collected 4 h post-surgery
Methodological detailsprospective, observational, single centre
- Prospective
- Observational
- Single centre
Performance
As reported in the abstract
AUC for stage 1 AKI (serum creatinine criteria)
| Test or model | AUC |
|---|---|
| NGAL | 0.741 (95%CI 0.699-0.770, p < 0.001) |
| IGFBP-7*TIMP-2 | 0.655 (95% CI 0.611-0.697, p0.003) |
| KIM-1 | 0.68, 95%CI 0.637-0.722 |
AUC
NGAL0.741 (95%CI 0.699-0.770, p < 0.001)
IGFBP-7*TIMP-20.655 (95% CI 0.611-0.697, p0.003)
KIM-10.68, 95%CI 0.637-0.722
Further findings
| Outcome | NGAL | IGFBP-7*TIMP-2 |
|---|---|---|
| AUC for stage 2 AKI (serum creatinine criteria) | ||
| AUC | 0.871 (95%CI 0.838-0.899, p < 0.001) | 0.803 (95%CI 0.764-0.837 p0.002) |
AUC for stage 2 AKI (serum creatinine criteria)
- KIM-1 not statistically significant for stage 2
AKI incidence by criteria
- AKI by urine output criteria
- 242 (49.5%)
- AKI by serum creatinine criteria
- 43 (8.8%)
AKI by urine output criteria
- Biomarkers performed poorly for prediction
Original publication
A prospective diagnostic study investigating urinary biomarkers of AKI in major abdominal surgery (the AKI-biomas study). Crit Care. Published 1 July 2025. doi:10.
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