PROGNOSTIC VALUE OF URINARY TISSUE INHIBITOR OF METALLOPROTEINASE-2 (TIMP-2) AND INSULIN-LIKE GROWTH FACTOR BINDING PROTEIN 7 (IGFBP-7)FOR CONTRAST-INDUCED ACUTE KIDNEY INJURY: A LITERATURE REVIEW

Abstract

Relevance: Contrast-induced acute kidney injury (CI-AKI) is a serious complication of medical procedures using contrast agents. Despite the decrease in the incidence of acute kidney injury (AKI), CI-AKI remains one of the leading causes of renal function deterioration, especially in emergencies. Serum creatinine (SCr) is not a reliable biomarker for early diagnosis since its level increases only when more than 50% of renal mass is lost. Modern iodinated contrast agents (ICA) reduce the risk of AKI but remain dangerous for patients with chronic kidney disease (CKD) and diabetes.
The study aimed to summarize published studies of TIMP-2 and IGFBP-7 early biomarkers to improve the diagnosis and prognosis of contrast-induced acute kidney injury.
Methods: The sources were searched in Pubmed, Web of Science, and Cochrane databases. The review included 21 sources published from 2014 to 2025.
Results: Iodized contrasts are widely used in clinical procedures. They increase the risk of CI-AKI, with intensive therapy remaining the only supportive measure. [TIMP-2]·[IGFBP7] biomarkers predict the development of severe AKI (KDIGO stage 2/3), mortality, and AKI severity with high sensitivity and accuracy. Elevated levels of these biomarkers are associated with the risk of death or dialysis within 9 months, making them useful for close patient monitoring.
Conclusion: Recent studies have highlighted the importance of early diagnosis of CI-AKI using IGFBP-7 and TIMP-2 biomarkers, which is important for early intervention and improved treatment outcomes. Further studies will help improve the understanding and management of this complication, considering risk factors such as creatinine levels, diabetes, and heart failure. The need for safe and effective methods for diagnosing and preventing CI-AKI is relevant both in Kazakhstan and abroad. Careful monitoring of high-risk patients and tailoring AKI management to individual patient needs can improve clinical practice and reduce the incidence of end-stage kidney failure.