In this cohort study of critically ill patients with septic shock from the Protocolized Care for Early Septic Shock (ProCESS) trial,19 we explored whether higher levels of [TIMP-2] × [IGFBP7], measured nearly simultaneously with assessment of AKI, could identify patients with reduced survival among those at the same functional AKI stage. This evidence concerns the gene IGFBP7 and acute kidney injury.