The Role of IGFBP-7 in Predicting Contrast-Induced Acute Kidney Injury

Abstract

Background: Acute kidney injury (AKI) is a significant complication associated with the administration of contrast media, leading to increased morbidity and healthcare costs. Insulin-like growth factor binding protein-7 (IGFBP-7) has emerged as a potential biomarker for predicting AKI. This study aims to evaluate the role of IGFBP-7 in predicting contrast-induced AKI (CI-AKI). Methods: ELISA test was used to quantify serum levels of Cr and IGFBP7. Serum levels of Cr and IGFBP-7 were measured pre- and post- two days of contrast exposure. Statistical analyses included sensitivity, specificity, and receiver operating characteristic (ROC) curves to assess the predictive power of IGFBP-7 and IGFBP-7/Cr. Results: A total of 938 patients were enrolled, with a reported incidence of CI-AKI at 4.7%. Elevated levels of IGFBP-7 and IGFBP-7/Cr were significantly associated with the development of AKI (p < 0.001). ROC curve analysis revealed an area under the curve (AUC) of 0.997 and 0.947 respectively, indicating good predictive accuracy. The optimal cutoff level for IGFBP-7 and IGFBP-7/Cr was determined to be 1.807 ng/mL and 0.1492 respectively, with a sensitivity of 97% and 90% and specificity of 99% and 97% respectively. Conclusions: Our findings suggest that IGFBP-7 and IGFBP-7/Cr is a promising biomarker for the early prediction of contrast-induced acute kidney injury. Implementing routine measurement of IGFBP-7 may enhance the clinical management of patients at risk for CI-AKI, allowing for timely interventions to mitigate renal damage. Further prospective studies are warranted to validate these results and establish clinical guidelines for its use.