Our results of the derivation cohort highlight the utility and importance of initial and peak urinary TIMP-1 in critically ill children, which is similar to urinary NGAL, KIM-1 and TIMP-2 and has an increased predictive value relative to other urinary biomarkers, such as FABP-1, IGFBP7, IP-10, renin, and TTF-3, as assessed by AUCs, for the prediction of AKI stage 3 or death. The gene discussed is TIMP1; the disease is acute kidney injury.