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The insulin-like growth factor (IGF) binding protein superfamily consists of six high-affinity IGf-binding proteins (IGFBP) and at least four other low-affinity binding proteins, called igFBP-associated proteins (IGFBP-RP). IGFBP7 is a low-affinity IGF-binding protein that plays an integral role in regulating insulin-like growth factor (IGF) action in a variety of cell types, including stimulation of prostacycline production and cell adhesion. Some IGFBPs may also have intrinsic biological activity independent of their ability to bind to IGF proteins. IGFBP7 levels have been linked to the development of cancer. Loss of IGFBP7 expression is associated with poor survival and tumor chemotherapy resistance in many cancer types. IGFBP7 has also been identified as a biomarker of cell cycle arrest in human acute kidney injury and as a prognostic indicator for the development of early acute kidney injury.