Tao X, Chen C, Luo W, et al. - The most common trigger for AKI is sepsis and there are up to 40% of mild or moderate septic AKI that progress to more severe AKI, which is linked with significantly raised risk for death and later CKD/ESRD. Researchers aimed at determining the factors that may aid in early identification of high risk patients for AKI progression in patients with septic AKI.

• In this multicenter cohort study, 433 patients were screened; of whom, 149 patients with sepsis and stage 1 or 2 AKI were enrolled.

• Progressive AKI developed in 63 patients and subsequent death occurred during hospitalization in 49 patients.

• For the progression of septic AKI, following were independent predictors: u[TIMP-2]*[IGFBP7], uKIM-1 and uIL-18; among these, u[TIMP-2]*[IGFBP7] showed the greatest AUC.

• The performance of predicting septic AKI progression improved in correlation with applying combination of u[TIMP-2]*[IGFBP7] with uKIM-1.

• u[TIMP-2]*[IGFBP7], alone or combined with uKIM-1/uIL-18, had superior value for risk reclassification over the clinical risk factor model alone both for AKI progression and AKI progression with subsequent death during hospitalization.

• In patients with sepsis, combination of renal cell arrest and damage biomarkers allowed improvement in the prediction of AKI progression and improvement in risk reclassification over the clinical risk factors.