Background: Patients with hepatorenal syndrome carry a high short-term mortality. Early diagnosis and treatment are essential for patients' outcome. Nevertheless diagnosis of HRS remains difficult. First-line therapy terlipressin is often associated with severe complications. Biomarkers become more on focus for an early diagnosis. Objective: The aim of this study was to test the diagnostic accuracy of urinary [TIMP-2]·[IGFBP7] for HRS patients and prognostic value for therapy responding patients. Material and methods: NephroCheck® measures urinary concentrations of TIMP-2 and IGFBP-7, both indicating stress of renal cells and associated with induction of cell cycle arrest. 22 HRS patients and 30 patients with normal kidney function were included. [TIMP-2]·[IGFBP7] was measured using NephroCheck®. HRS patients receiving terlipressin were also examined. Results: [TIMP-2]·[IGFBP7] values did not differ significantly (1.3 ± 2.09 vs. 1.03 ± 1.03; p = 0.55). Furthermore, there was no significant difference of [TIMP-2]·[IGFBP7] regarding response of terlipressin (1.32 ± 2.39 vs. 0.81 ± 1.05; p = 0.56). Low [TIMP-2]·[IGFBP7] values were significantly associated with higher mortality (p = 0.01). Conclusions: The results of this study suggest that [TIMP-2]·[IGFBP7] is not suitable for diagnostic of HRS and prediction of therapy response, but there might be evidence for prognostic value of [TIMP-2]·[IGFBP7] in regard to mortality of liver cirrhosis patients.

中文翻译：

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肝肾综合征患者尿液细胞周期阻滞生物标志物[TIMP-2]·[IGFBP7]。

背景：肝肾综合征患者的短期死亡率很高。早期诊断和治疗对于患者的预后至关重要。然而，HRS的诊断仍然困难。一线治疗特利加压素通常伴有严重并发症。生物标志物越来越成为早期诊断的重点。目的：本研究的目的是检验尿液[TIMP-2]·[IGFBP7]对HRS患者的诊断准确性以及对治疗有反应的患者的预后价值。材料和方法：NephroCheck®测量TIMP-2和IGFBP-7的尿液浓度，既指示肾细胞的压力，又与诱导细胞周期停滞有关。包括22例HRS患者和30例肾功能正常的患者。[TIMP-2]·[IGFBP7]是使用NephroCheck®测定的。还对接受特利加压素的HRS患者进行了检查。结果：[TIMP-2]·[IGFBP7]值无显着差异（1.3±2.09对1.03±1.03； p = 0.55）。此外，关于特利加压素的反应，[TIMP-2]·[IGFBP7]没有显着差异（1.32±2.39对0.81±1.05； p = 0.56）。低[TIMP-2]·[IGFBP7]值与较高的死亡率显着相关（p = 0.01）。结论：本研究结果提示[TIMP-2]·[IGFBP7]不适合用于HRS的诊断和治疗反应的预测，但[TIMP-2]·[IGFBP7]的预后价值可能存在证据。关于肝硬化患者的死亡率。关于特利加压素的反应，[TIMP-2]·[IGFBP7]没有显着差异（1.32±2.39对0.81±1.05； p = 0.56）。低[TIMP-2]·[IGFBP7]值与较高的死亡率显着相关（p = 0.01）。结论：本研究结果提示[TIMP-2]·[IGFBP7]不适合用于HRS的诊断和治疗反应的预测，但[TIMP-2]·[IGFBP7]的预后价值可能存在证据。关于肝硬化患者的死亡率。关于特利加压素的反应，[TIMP-2]·[IGFBP7]没有显着差异（1.32±2.39对0.81±1.05； p = 0.56）。低[TIMP-2]·[IGFBP7]值与较高的死亡率显着相关（p = 0.01）。结论：本研究结果提示[TIMP-2]·[IGFBP7]不适合用于HRS的诊断和治疗反应的预测，但[TIMP-2]·[IGFBP7]的预后价值可能存在证据。关于肝硬化患者的死亡率。