Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 0 0 2026 10 04 1 13 Yabin Zhang Department of Nephrology, The Second Medical Center of Chinese PLA General Hospital, Beijing, China Qiangguo Ao Department of Nephrology, The Second Medical Center of Chinese PLA General Hospital, Beijing, China Mengkun Li Department of Nephrology, The Second Medical Center of Chinese PLA General Hospital, Beijing, China Xuwei He Department of Nephrology, The Second Medical Center of Chinese PLA General Hospital, Beijing, China Qingli Cheng Department of Nephrology, The Second Medical Center of Chinese PLA General Hospital, Beijing, China 2026 05 09 2026 06 14 Acute kidney injury (AKI) presents challenges for early risk stratification due to its rapid progression and variable outcomes. This study investigated the predictive value of serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and fibroblast growth factor 2 (FGF-2) for disease progression and clinical outcomes in 104 AKI patients. Serum biomarkers were measured at diagnosis. Disease progression (worsening of AKI stage) and 28-day major adverse kidney events (MAKE) were assessed. IL-6 and TNF-α positively correlated with progression and MAKE, while FGF-2 showed negative correlations. Multivariate logistic regression identified IL-6 (aOR=1.034) and TNF-α (aOR=1.082) as independent predictors of progression, but not FGF-2. Cox regression showed TNF-α independently predicted earlier MAKE (aHR=1.031), whereas FGF-2 predicted delayed MAKE (aHR=0.832). IL-6 did not independently affect time to MAKE. The combined biomarker model achieved an AUC of 0.962 for predicting MAKE. Day-of-diagnosis measurement of IL-6, TNF-α, and FGF-2 is significantly associated with AKI progression and adverse outcomes, independent of traditional risk factors. Evaluating the balance between inflammation and repair may improve risk stratification. The combination of elevated IL-6 and TNF-α with decreased FGF-2 could identify a high-risk phenotype. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/4830 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/4830/2431