Observational studyCritical care (London, England)2025
A prospective diagnostic study investigating urinary biomarkers of AKI in major abdominal surgery (the AKI-biomas study).
Observational study in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Beyond creatinine: diagnostic accuracy of emerging biomarkers for AKI in the ICU - a systematic review.Renal failure · 2025Pooled it
- Eight weeks of MitoQ supplementation does not alter kidney function or urinary kidney injury biomarkers in middle-aged and older adults.American journal of physiology. Renal physiology · 2026Trial
- Stress hyperglycemia ratio as a predictor of in-hospital mortality in patients with acute kidney injury: a retrospective cohort study.Clinical and experimental nephrology · 2026Article
- The Role of Biomarkers in Personalized Anesthesia: From Physiological Parameters to Molecular Diagnostics.Biomedicines · 2026Review
- Acute Kidney Injury Biomarkers in Perioperative Care: A Scoping Review of Clinical Implementation.Diagnostics (Basel, Switzerland) · 2025Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPost-operative acute kidney injury (AKI) is associated with increased morbidity and mortality with evidence suggesting that early identification using biomarkers of AKI may impact prognosis. Most studies in surgical patients has focussed on cardiac, vascular and transplant surgery cohorts. Evidence on the utility of biomarkers in major abdominal surgery is sparse.
methodsThis was a prospective observational single centre diagnostic study conducted on 488 patients undergoing major abdominal surgery. Urine was collected four hours post-surgery. The biomarkers for AKI NGAL, KIM-1, DKK-3 and IGFBP-7*TIMP-2 were measured and diagnostic performance assessed utilising Receiver Operating Characteristic (ROC) curve analysis to predict the development of post operative AKI using serum creatinine and urine output criteria.
results242 participants developed AKI by urine output criteria (49.5%) and 43 by serum creatinine criteria (8.8%). The area under the receiver operating characteristic curve values for stage 1 AKI as determined by serum creatinine criteria for NGAL was 0.741 (95%CI 0.699-0.770, p < 0.001) and 0.871 (95%CI 0.838-0.899, p < 0.001) for stage 2. AUC values for IGFBP-7*TIMP-2 for stage 1 were 0.655 (95% CI 0.611-0.697, p0.003) and stage 2 0.803 (95%CI 0.764-0.837 p0.002). The AUC for KIM-1 was statistically significant for stage 1 (0.68, 95%CI 0.637-0.722) but not for stage 2. No AUC values for DKK-3 were statistically significant. Biomarkers performed poorly for prediction of AKI by urine output criteria.
conclusionsIn this large prospective study of a clinical cohort of 488 patients undergoing major abdominal surgery AKI rates are dependent on the criteria used with 49.5% of patients developed AKI by urine output criteria, compared to only 8.8% by serum creatinine. NGAL and IGFBP-7*TIMP-2 showed reasonable diagnostic performance when diagnosing AKI by serum creatinine criteria, with NGAL returning the highest AUC values.
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