Table 4.
Summary of the diagnostic meta-analysis in the ICU and non-ICU population
| Population/marker | No. of study | Sensitivity, % (95% CI) | Specificity, % (95% CI) | DOR (95% CI) | Relative sensitivity (95% CI) | Relative specificity (95% CI) | Relative DOR (95% CI) |
|---|---|---|---|---|---|---|---|
| ICU population | |||||||
| NGAL | 27 | 76.2 (71.0–80.7) | 78.6 (74.3–82.3) | 11.8 (8.6–16.1) | Reference | Reference | Reference |
| IL-18 | 8 | 65.4 (55.3–74.2) | 80.4 (75.7–84.3) | 7.7 (4.8–12.3) | 0.86 (0.75–0.98)* | 1.02 (0.99–1.06) | 0.66 (0.42–1.02) |
| IL-18/Cr | 3 | 69.0 (59.3–77.2) | 79.5 (73.3–84.5) | 8.6 (5.2–14.4) | 0.91 (0.80–1.02) | 1.01 (0.95–1.07) | 0.73 (0.45–1.20) |
| KIM-1 | 7 | 74.1 (65.0–81.5) | 77.7 (71.3–83.1) | 10.0 (5.9–16.8) | 0.97 (0.87–1.08) | 0.99 (0.93–1.05) | 0.85 (0.52–1.40) |
| KIM-1/Cr | 4 | 65.8 (55.0–75.2) | 83.8 (78.5–88.0) | 9.9 (5.8–17.1) | 0.86 (0.75–1.001) | 1.07 (1.01–1.12)* | 0.85 (0.50–1.43) |
| L-FABP | 9 | 69.4 (59.8–77.5) | 80.2 (74.5–84.9) | 9.2 (5.6–15.0) | 0.91 (0.81–1.03) | 1.02 (0.97–1.08) | 0.78 (0.48–1.27) |
| L-FABP/Cr | 6 | 84.0 (74.3–90.6) | 69.6 (58.0–79.2) | 12.1 (5.8–25.1) | 1.10 (0.99–1.23) | 0.89 (0.76–1.03) | 1.03 (0.48–2.21) |
| NGAL/Cr | 7 | 68.1 (59.1–76.0) | 85.5 (81.0–89.1) | 12.6 (7.8–20.2) | 0.89 (0.80–1.01) | 1.09 (1.04–1.14)* | 1.07 (0.68–1.69) |
| Serum NGAL | 26 | 75.3 (69.8–80.0) | 78.2 (73.8–82.1) | 11.0 (8.0–15.1) | 0.99 (0.92–1.06) | 1.00 (0.97–1.02) | 0.93 (0.69–1.26) |
| TIMP-2 × IGFBP-7: custom | 5 | 89.8 (79.0–95.3) | 57.5 (43.0–70.9) | 11.9 (4.5–31.1) | 1.18 (1.06–1.31)* | 0.73 (0.57–0.94)* | 1.01 (0.37–2.79) |
| TIMP-2 × IGFBP-7: 0.3 | 15 | 67.9 (57.9–76.5) | 73.9 (64.8–81.3) | 6.0 (3.6–10.0) | 0.89 (0.77–1.04) | 0.94 (0.83–1.06) | 0.51 (0.28–0.92)* |
| TIMP-2 × IGFBP-7: 2 | 9 | 18.1 (11.9–26.6) | 97.4 (95.7–98.4) | 8.1 (4.3–15.3) | 0.24 (0.16–0.36) | 1.24 (1.18–1.31) | 0.69 (0.34–1.40) |
| Non-ICU population | |||||||
| NGAL | 8 | 75.8 (65.0–84.1) | 84.5 (76.4–90.2) | 17.1 (7.8–37.5) | Reference | Reference | Reference |
| IL-18 | 4 | 68.2 (54.8–79.1) | 81.7 (72.3–88.4) | 9.6 (4.2–21.9) | 0.90 (0.79–1.03) | 0.97 (0.93–0.999)* | 0.56 (0.35–0.91)* |
| KIM-1 | 7 | 77.4 (66.2–85.7) | 82.4 (73.2–88.9) | 16.0 (7.0–36.2) | 1.02 (0.92–1.13) | 0.97 (0.94–1.01) | 0.93 (0.58–1.51) |
| KIM-1/Cr | 2 | 92.0 (50.2–99.2) | 58.8 (34.4–79.5) | 16.4 (1.1–237.5) | 1.21 (0.96–1.53) | 0.70 (0.46–1.04) | 0.96 (0.06–14.79) |
| L-FABP/Cr | 2 | 75.7 (46.1–91.9) | 92.1 (68.5–98.4) | 36.0 (3.7–349.5) | 0.999 (0.71–1.40) | 1.09 (0.93–1.27) | 2.11 (0.19–23.38) |
| NGAL/Cr | 2 | 93.5 (64.1–99.1) | 87.4 (65.1–96.3) | 99.3 (7.7–1285.0) | 1.23 (1.02–1.49)* | 1.03 (0.86–1.24) | 5.81 (0.41–83.40) |
| Serum NGAL | 14 | 77.2 (67.5–84.7) | 81.6 (72.7–88.1) | 15.0 (7.1–32.0) | 1.02 (0.87–1.19) | 0.97 (0.87–1.07) | 0.88 (0.35–2.20) |
| TIMP-2 × IGFBP-7: 0.3 | 2 | 73.0 (42.4–90.9) | 61.2 (26.3–87.5) | 4.3 (0.5–36.4) | 0.96 (0.66–1.40) | 0.72 (0.40–1.30) | 0.25 (0.03–2.45) |
| TIMP-2 × IGFBP-7: 2 | 2 | 25.9 (8.6–56.5) | 95.6 (82.2–99.0) | 7.6 (0.8–67.9) | 0.34 (0.13–0.91)* | 1.13 (1.02–1.26)* | 0.44 (0.04–4.56) |
CI confidence interval, Cr creatinine, DOR diagnostic odds ratio, ICU intensive care unit, IL-18 interleukin-18, KIM-1 kidney injury molecule-1, L-FABP liver-type fatty acid-binding protein, NGAL neutrophil gelatinase-associated lipocalin, TIMP-2 × IGFBP-7 tissue inhibitor of metalloproteinases-2 × insulin-like growth factor-binding protein-7
*Numbers in bold indicate significant difference (P < 0.05) versus the referent category: “NGAL”