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Corresponding Author

Mohamed Ahmed Elsheikh

Document Type

Original Article

Abstract

Background: The development of Hepatorenal Syndrome (HRS) is a notable consequence of severe cirrhosis. While the urinary tissue inhibitor of metalloproteinases-2 (UTIMP-2) biomarker is valuable for detecting Acute Kidney Injury (AKI), its application in patients with Hepatorenal Syndrome (HRS) has not been thoroughly investigated.

Purpose: To assess the diagnostic accuracy of UTIMP-2 in cases diagnosed with hepatorenal syndrome (HRS).

Patients and methods: This case-controlled study involved a total of 90 patients from internal medicine wards and Intensive Care Units of Al-Hussein and Sayed Galal University hospitals, divided equally into three groups: those with decompensated cirrhosis and HRS (group I), those with decompensated cirrhosis without HRS (group II), and patients without cirrhosis but with AKI (group III), matched with 30 healthy controls (group IV). All participants underwent a thorough clinical examination, laboratory investigations, complete biochemical and microscopic analysis of urine samples, evaluation for UTIMP-2, and radiological examination.

Results: UTIMP-2 levels were notably increased in Groups I, II, and III than controls (63.93 ± 16.1 vs. 44.54 ± 4.18 vs. 68.41 ± 14.75 vs. 18.6 ± 2.79 ng/dl, P<0.0001 for each). Groups I and III showed a more substantial increase than Group II relative to the control group. A UTIMP-2 level of ≥48.3 ng/ml had an 88.33% sensitivity and a 96.67% specificity in predicting HRS among cirrhotic patients (AUC=0.939, P<0.0001). UTIMP-2 levels showed no statistically significant correlations with any of the laboratory variables among patients in Group I.

Conclusions: In patients with liver cirrhosis, UTIMP-2 is a reliable predictor of HRS.

Keywords

UTIMP-2, Acute kidney injury, Cirrhosis, Hepatorenal Syndrome

Subject Area

Internal Medicine

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