Table 5.
Combination of clinical model and AKI markers at inclusion for predicting renal recovery and major adverse kidney events
| Combination | AUC-ROC | P Value | Integrated Discrimination Improvement | P Value | Category-Free Net Reclassification Improvement | P Value | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| Events | Nonevents | Overall | Events | Nonevents | Overall | |||||
| Renal recovery | ||||||||||
| Clinical model | 0.87 (0.78 to 0.96) | NA | NA | NA | NA | NA | NA | NA | NA | NA |
| Clinical model + RI | 0.90 (0.82 to 0.99) | 0.39 | 0.06 (0.02 to 0.11) | 0.003 (−0.04 to 0.04) | 0.07 (0.004 to 0.13) | 0.04 | 0.57 (0.27 to 0.88) | 0.50 (0.15 to 0.84) | 1.07 (0.61 to 1.53) | <0.001 |
| Clinical model + plasma NGAL | 0.88 (0.79 to 0.96) | 0.75 | 0.01 (−0.02 to 0.04) | 0.01 (−0.02 to 0.04) | 0.02 (−0.02 to 0.07) | 0.29 | 0.43 (0.09 to 0.76) | 0.36 (0.09 to 0.76) | 0.79 (0.30 to 1.27) | 0.003 |
| Clinical model + [TIMP-2]*[IGFBP7] | 0.89 (0.81 to 0.97) | 0.36 | 0.02 (−0.01 to 0.06) | 0.02 (−0.02 to 0.06) | 0.04 (−0.02 to 0.10) | 0.15 | 0.50 (−0.03 to 0.07) | 0.07 (−0.30 to 0.44) | 0.57 (0.08 to 1.06) | 0.03 |
| Clinical model + kinetic eGFR (ml/min per 1.73 m2) | 0.87 (0.78 to 0.96) | 0.57 | 0.02 (−0.01 to 0.04) | 0.01 (−0.04 to 0.06) | 0.03 (−0.03 to 0.08) | 0.32 | 0.43 (0.09 to 0.76) | 0.12 (−0.27 to 0.51) | 0.55 (0.04 to 1.06) | 0.05 |
| Clinical model + plasma NGAL + [TIMP-2]*[IGFBP7] | 0.89 (0.81 to 0.97) | 0.41 | 0.03 (−0.02 to 0.08) | 0.03 (−0.01 to 0.07) | 0.06 (−0.008 to 0.13) | 0.09 | 0.50 (−0.01 to 0.07) | 0.36 (0.01 to 0.70) | 0.86 (0.39 to 1.33) | 0.001 |
| Clinical model + RI + plasma NGAL + [TIMP-2]*[IGFBP7] | 0.92 (0.84 to 0.99) | 0.18 | 0.07 (0.01 to 0.12) | 0.008 (−0.04 to 0.06) | 0.07 (0.004 to 0.15) | 0.04 | 0.43 (0.09 to 0.76) | 0.33 (−0.04 to 0.71) | 0.76 (0.26 to 1.27) | 0.01 |
| Clinical model + RI + plasma NGAL + [TIMP-2]*[IGFBP7] + kinetic eGFR | 0.89 (0.80 to 0.98) | 0.48 | 0.07 (0.01 to 0.13) | 0.008 (−0.05 to 0.07) | 0.08 (−0.003 to 0.16) | 0.06 | 0.50 (0.18 to 0.82) | 0.24 (−0.18 to 0.65) | 0.74 (0.21 to 1.26) | 0.01 |
| Major adverse kidney events | ||||||||||
| Clinical model | 0.89 (0.79 to 0.99) | NA | NA | NA | NA | NA | NA | NA | NA | NA |
| Clinical model + RI | 0.91 (0.83 to 0.98) | 0.36 | 0.04 (−0.03 to 0.11) | 0.005 (−0.03 to 0.04) | 0.04 (−0.04 to 0.12) | 0.29 | 0.20 (−0.30 to 0.70) | 0.30 (−0.01 to 0.60) | 0.50 (−0.09 to 1.08) | 0.10 |
| Clinical model + plasma NGAL | 0.88 (0.78 to 0.98) | 0.76 | 0.005 (−0.03 to 0.04) | 0.002 (−0.01 to 0.01) | 0.007 (−0.03 to 0.04) | 0.67 | 0.12 (−0.36 to 0.61) | 0.07 (−0.36 to 0.61) | 0.20 (−0.38 to 0.77) | 0.50 |
| Clinical model + [TIMP-2]*[IGFBP7] | 0.89 (0.80 to 0.98) | 0.65 | 0.01 (−0.03 to 0.05) | 0.004 (−0.01 to 0.02) | 0.02 (−0.03 to 0.06) | 0.49 | 0.25 (−0.22 to 0.72) | 0.32 (−0.22 to 0.72) | 0.57 (0.01 to 1.12) | 0.05 |
| Clinical model + kinetic eGFR | 0.87 (0.76 to 0.99) | 0.71 | 0.02 (−0.05 to 0.08) | 0.02 (−0.01 to 0.04) | 0.03 (−0.04 to 0.10) | 0.36 | 0.23 (−0.30 to 0.76) | 0.41 (0.14 to 0.69) | 0.65 (0.05 to 1.24) | 0.04 |
| Clinical model + plasma NGAL + [TIMP-2]*[IGFBP7] | 0.89 (0.80 to 0.98) | 0.67 | 0.01 (−0.03 to 0.06) | 0.005 (−0.01 to 0.02) | 0.02 (−0.03 to 0.07) | 0.47 | 0.25 (−0.22 to 0.72) | 0.07 (−0.23 to 0.3 8) | 0.32 (−0.24 to 0.89) | 0.27 |
| Clinical model + RI + plasma NGAL + [TIMP-2]*[IGFBP7] | 0.91 (0.83 to 0.98) | 0.41 | 0.05 (−0.03 to 0.12) | 0.009 (−0.03 to 0.05) | 0.06 (−0.03 to 0.14) | 0.18 | 0.20 (−0.30 to 0.70) | 0.35 (0.05 to 0.65) | 0.55 (−0.03 to 1.13) | 0.07 |
| Clinical model + RI + plasma NGAL + [TIMP-2]*[IGFBP7] + kinetic eGFR (ml/min per 1.73 m2) | 0.93 (0.86 to 1) | 0.13 | 0.15 (−0.03 to 0.33) | 0.05 (0.01 to 0.09) | 0.20 (0.02 to 0.38) | 0.03 | 0.33 (−0.20 to 0.87) | 0.51 (0.24 to 0.79) | 0.85 (0.25 to 1.45) | 0.01 |
Data are presented with 95% confidence intervals in parentheses. P values are compared with the clinical model. Major adverse kidney events were defined as death, use of RRT, or persistence of renal dysfunction (defined by serum creatinine ≥200% of the reference) at hospital discharge truncated at 30 days. RI, renal resistive index; NGAL, neutrophil gelatinase–associated lipocalin; [TIMP-2]*[IGFBP7], tissue inhibitor of metalloproteinase-2 and urine insulin-like growth factor–binding protein 7; AUC-ROC, area under the receiver-operating characteristic curve; NA, not available.