Perioperative Urinary TIMP-2*IGFBP7 and Acute Kidney Injury: A Systematic Review

Acute kidney injury (AKI) is a common post-operative outcome after major surgery. Many studies strive to improve the timeliness of identifying a surgical-associated AKI using novel renal biomarkers. However, there are limited studies focusing on the intraoperative phase of adult patient populations. The purpose of this review is to identify, evaluate, and summarize the current literature for use of the novel renal biomarkers urinary tissue inhibitor of metalloproteinase-2 * insulin-like growth factor binding protein 7 (uTIMP-2*IGFBP7) for early identification of AKI during the perioperative period for adult patients having major surgery. Databases searched include CINAHL, ProQuest, Scopus, and PubMed. One additional article was found through reference review. The literature search followed the PRISMA guideline. Twelve articles were reviewed and synthesized regarding the ability of uTIMP-2*IGFBP7 to early identify AKI during the perioperative period. The majority of studies reviewed report high sensitivity of uTIMP-2*IGFBP7 to identify surgical-associated AKI (AUROC >0.8); however, there is no consensus regarding the ideal time point for measurement or the cut-off values.