Titeca-Beauport D, et al. - Researchers investigated the value of tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) as urine biomarkers for identification of patients who will develop severe acute kidney injury (AKI) soon after cardiac arrest. In this prospective, multicenter study in three French ICUs, 115 patients were analyzed. Severe AKI developed in 32 (28%) of these patients; renal replacement therapy was administered in 11 of these. Patients who developed severe AKI had higher median baseline [TIMP-2]*[IGFBP7] level than those who did not. Baseline [TIMP-2]*[IGFBP7] vs baseline SCr was significantly more discerning, while vs baseline UO was slightly but not significantly more discerning for predicting severe AKI. The predictive performance of baseline SCr and UO significantly improved when combined with the baseline [TIMP2]*[IGFBP7]. These findings support the efficacy of urine [TIMP-2]*[IGFBP7] in the identification of patients with a risk of severe AKI. The risk of severe AKI is noted to be low below a cut-off of 0.39 (ng/ml)2/1,000.