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Table 3 Consensus statements for potential actions after positive and negative [TIMP-2]•[IGFBP7] testing

From: Clinical use of [TIMP-2]•[IGFBP7] biomarker testing to assess risk of acute kidney injury in critical care: guidance from an expert panel

Positive test (> 0.3) Negative test (≤ 0.3)
 • Discontinue all nonessential nephrotoxins (e.g., NSAIDs)
 • Avoid vancomycin or dose adjust
 • Goal-directed fluid/diuretic management*
• Standard of care or fast-track
• Repeat [TIMP-2]•[IGFBP7] test if additional exposures occur
• Consider diuretics to maintain fluid balance
 • Discontinue all ACE inhibitors and/or ARBs
 • Maintain close UO monitoring
 • Review meds with clinical pharmacist
 • Retain invasive hemodynamic monitoring
 • Avoid saline
 
 • Consult nephrology
 • Repeat [TIMP-2]•[IGFBP7] test in 12–24 h
 • Consult intensive care
 
  1. *Includes bedside ultrasound, and functional hemodynamic monitoring
  2. Actions are listed in order of priority. High priority (> 30 out of a possible 48) was assigned to the top 5 actions. Actions that received a score < 12 (equivalent to low priority by all participants and more than 25% of participants not supporting at all) were removed from the list