Table 5.

Combination of clinical model and AKI markers at inclusion for predicting renal recovery and major adverse kidney events

CombinationAUC-ROCP ValueIntegrated Discrimination ImprovementP ValueCategory-Free Net Reclassification ImprovementP Value
EventsNoneventsOverallEventsNoneventsOverall
Renal recovery
 Clinical model0.87 (0.78 to 0.96)NANANANANANANANANA
 Clinical model + RI0.90 (0.82 to 0.99)0.390.06 (0.02 to 0.11)0.003 (−0.04 to 0.04)0.07 (0.004 to 0.13)0.040.57 (0.27 to 0.88)0.50 (0.15 to 0.84)1.07 (0.61 to 1.53)<0.001
 Clinical model + plasma NGAL0.88 (0.79 to 0.96)0.750.01 (−0.02 to 0.04)0.01 (−0.02 to 0.04)0.02 (−0.02 to 0.07)0.290.43 (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)0.360.02 (−0.01 to 0.06)0.02 (−0.02 to 0.06)0.04 (−0.02 to 0.10)0.150.50 (−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)0.570.02 (−0.01 to 0.04)0.01 (−0.04 to 0.06)0.03 (−0.03 to 0.08)0.320.43 (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)0.410.03 (−0.02 to 0.08)0.03 (−0.01 to 0.07)0.06 (−0.008 to 0.13)0.090.50 (−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)0.180.07 (0.01 to 0.12)0.008 (−0.04 to 0.06)0.07 (0.004 to 0.15)0.040.43 (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 eGFR0.89 (0.80 to 0.98)0.480.07 (0.01 to 0.13)0.008 (−0.05 to 0.07)0.08 (−0.003 to 0.16)0.060.50 (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 model0.89 (0.79 to 0.99)NANANANANANANANANA
 Clinical model + RI0.91 (0.83 to 0.98)0.360.04 (−0.03 to 0.11)0.005 (−0.03 to 0.04)0.04 (−0.04 to 0.12)0.290.20 (−0.30 to 0.70)0.30 (−0.01 to 0.60)0.50 (−0.09 to 1.08)0.10
 Clinical model + plasma NGAL0.88 (0.78 to 0.98)0.760.005 (−0.03 to 0.04)0.002 (−0.01 to 0.01)0.007 (−0.03 to 0.04)0.670.12 (−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)0.650.01 (−0.03 to 0.05)0.004 (−0.01 to 0.02)0.02 (−0.03 to 0.06)0.490.25 (−0.22 to 0.72)0.32 (−0.22 to 0.72)0.57 (0.01 to 1.12)0.05
 Clinical model + kinetic eGFR0.87 (0.76 to 0.99)0.710.02 (−0.05 to 0.08)0.02 (−0.01 to 0.04)0.03 (−0.04 to 0.10)0.360.23 (−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)0.670.01 (−0.03 to 0.06)0.005 (−0.01 to 0.02)0.02 (−0.03 to 0.07)0.470.25 (−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)0.410.05 (−0.03 to 0.12)0.009 (−0.03 to 0.05)0.06 (−0.03 to 0.14)0.180.20 (−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)0.130.15 (−0.03 to 0.33)0.05 (0.01 to 0.09)0.20 (0.02 to 0.38)0.030.33 (−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.