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Test Code NEPH Nephrocheck AKIRISK Score

Specimen Type



Urine collection cup without additives

Preferred Volume

Optimal: 10 mL

Minimum: 1 mL

UCMC Collection Instructions

Collect a fresh urine sample of approximately 10 mL in a clean specimen collection cup without additives.  For patients with indwelling bladder catheters, the collection bag should first be emptied and then a fresh sample of urine should be collected.  Alternatively, the sample may be collected from an urometer, if present.


NOTE: Samples should be transferred to the laboratory and centrifuged within one hour of sample collection. 



Turnaround Time

3 hours

STAT Availability


STAT Turnaround Time

1 hour

Test Usage

The Astute Medical NEPHROCHECK® Test System is intended to be used in conjunction with clinical evaluation in ICU patients who currently have, or have had within the past 24 hours, acute cardiovascular and/or respiratory compromise as an aid in the risk assessment for moderate to severe AKI in the next 12 hours of patient assessment. The NEPHROCHECK® Test System is intended to be used in patients 21 years of age or older.

Test Methodology

The NEPHROCHECK® Test is a single-use cartridge comprised of assays for two protein biomarkers, TIMP-2 and IGFBP-7, on a membrane test strip enclosed in a plastic housing that employs a sandwich immunoassay technique. The ASTUTE140® Meter is a bench-top/table-top analyzer that converts the fluorescent signal from each of the two immunoassays, TIMP-2 and IGFBP-7, contained within the NEPHROCHECK® Test cartridge into a single numerical result that is called the AKIRISK™ Score.

Reference Range

Test results must always be evaluated with other data available to the physician. 

Test is intended for use in patients 21 yr of age or older.



Risk of Severe AKI

(doubling of serum creatinine or 12 hours of oliguria)

Action Suggested


Low Risk (<5% )1,2

Continue standard ICU care

0.3 to 2.0

Intermediate Risk (15-25%) 1,2

Optimize ICU care to minimize further risk of  AKI


High Risk (40-66%)1,2

Institute Maximal Kidney Protective Care to prevent further risk of AKI


1.  Hoste et al.  Nephrol Dial Transplant. 2014 Nov;29(11):2054-61
2.  Kashani et al.  Crit Care. 2013 Feb 6;17(1):R25.


See the attached document for treatment plan under the "Resources" header in the sidebar.

Critical Results


Additional Information



See the attached document under the "Resources" heading in the sidebar for test result interpretation and treatment plan.

CPT Code


Fee Code