Table 5.
Summary of the diagnostic meta-analysis in the medical/mixed and surgical 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) |
|---|---|---|---|---|---|---|---|
| Medical/mixed population | |||||||
| NGAL | 22 | 80.0 (74.7–84.4) | 81.8 (77.3–85.5) | 17.9 (12.3–26.3) | Reference | Reference | Reference |
| IL-18 | 7 | 61.0 (51.3–69.9) | 78.3 (72.8–82.9) | 5.6 (3.5–9.0) | 0.76 (0.67–0.87) | 0.96 (0.92–0.99)* | 0.31 (0.21–0.47)* |
| IL-18/Cr | 3 | 71.6 (62.0–79.6) | 80.0 (73.4–85.3) | 10.1 (5.8–17.6) | 0.90 (0.80–1.00) | 0.98 (0.92–1.04) | 0.56 (0.34–0.94)* |
| KIM-1 | 10 | 73.8 (66.3–80.2) | 78.5 (73.0–83.0) | 10.3 (6.6–16.0) | 0.92 (0.85–1.00)* | 0.96 (0.93–0.99)* | 0.57 (0.40–0.82)* |
| KIM-1/Cr | 4 | 69.7 (58.5–78.9) | 82.2 (75.5–87.3) | 10.6 (5.7–19.5) | 0.87 (0.76–1.00)* | 1.01 (0.95–1.07) | 0.59 (0.33–1.05) |
| L-FABP | 4 | 68.3 (57.9–77.2) | 79.3 (73.9–83.8) | 8.3 (4.9–13.9) | 0.85 (0.75–0.97)* | 0.97 (0.94–1.00) | 0.46 (0.30–0.71)* |
| L-FABP/Cr | 3 | 80.9 (68.7–89.1) | 68.2 (41.8–86.4) | 9.1 (2.6–31.5) | 1.01 (0.89–1.15) | 0.83 (0.59–1.18) | 0.50 (0.14–1.80) |
| NGAL/Cr | 6 | 71.4 (61.9–79.3) | 86.0 (81.0–89.7) | 15.3 (8.9–26.2) | 0.89 (0.80–1.00)* | 1.05 (1.01–1.10)* | 0.85 (0.52–1.39) |
| Serum NGAL | 27 | 77.5 (71.7–82.3) | 80.4 (75.7–84.4) | 14.1 (9.6–20.8) | 0.97 (0.91–1.03) | 0.98 (0.95–1.02) | 0.79 (0.56–1.11) |
| TIMP-2 × IGFBP-7: 0.3 | 6 | 70.9 (54.0–83.5) | 67.6 (49.7–81.5) | 5.1 (2.0–13.2) | 0.89 (0.71–1.11) | 0.83 (0.65–1.06) | 0.28 (0.10–0.79)* |
| TIMP-2 × IGFBP-7: 2 | 4 | 25.6 (13.7–42.6) | 96.6 (92.8–98.5) | 9.8 (3.5–27.2) | 0.32 (0.18–0.57)* | 1.18 (1.12–1.25) | 0.55 (0.18–1.63) |
| Surgical population | |||||||
| NGAL | 13 | 67.5 (57.9–75.9) | 75.5 (68.2–81.6) | 6.4 (3.7–11.2) | Reference | Reference | Reference |
| IL-18 | 5 | 76.1 (65.0–84.5) | 78.8 (71.7–84.5) | 11.8 (6.1–22.9) | 1.13 (0.98–1.29) | 1.04 (0.999–1.09) | 1.84 (1.08–3.13)* |
| KIM-1 | 4 | 85.8 (72.4–93.3) | 81.3 (71.7–88.2) | 26.2 (9.6–71.6) | 1.27 (1.09–1.49)* | 1.08 (0.98–1.18) | 4.09 (1.56–10.73)* |
| KIM-1/Cr | 2 | 71.8 (43.8–89.3) | 86.1 (77.5–91.7) | 15.7 (4.2–59.3) | 1.06 (0.75–1.50) | 1.14 (1.05–1.24)* | 2.45 (0.66–9.13) |
| L-FABP | 6 | 68.8 (55.6–79.6) | 87.1 (80.6–91.6) | 14.9 (7.0–31.5) | 1.02 (0.84–1.23) | 1.15 (1.07–1.24)* | 2.32 (1.12–4.81)* |
| L-FABP/Cr | 5 | 81.6 (69.4–89.7) | 76.5 (63.9–85.7) | 14.5 (5.8–36.2) | 1.21 (1.02–1.43)* | 1.01 (0.88–1.17) | 2.26 (0.86–5.93) |
| NGAL/Cr | 3 | 78.1 (56.1–90.9) | 90.6 (80.5–95.7) | 34.3 (9.0–130.6) | 1.16 (0.90–1.49) | 1.20 (1.08–1.33)* | 5.35 (1.35–21.17)* |
| Serum NGAL | 13 | 74.9 (65.9–82.2) | 76.6 (69.3–82.5) | 9.8 (5.5–17.4) | 1.11 (0.97–1.27) | 1.01 (0.97–1.06) | 1.52 (0.91–2.55) |
| TIMP-2 × IGFBP-7: custom | 5 | 81.5 (66.4–90.8) | 56.1 (39.8–71.1) | 5.6 (2.0–16.1) | 1.21 (0.99–1.48) | 0.74 (0.55–1.005) | 0.88 (0.27–2.88) |
| TIMP-2 × IGFBP-7: 0.3 | 11 | 65.7 (53.1–76.3) | 74.5 (62.6–83.6) | 5.6 (2.6–12.2) | 0.97 (0.78–1.22) | 0.99 (0.84–1.17) | 0.87 (0.34–2.27) |
| TIMP-2 × IGFBP-7: 2 | 7 | 13.9 (7.9–23.2) | 97.3 (94.8–98.6) | 5.8 (2.3–15.0) | 0.21 (0.12–0.36) | 1.29 (1.18–1.41) | 0.91 (0.31–2.72) |
CI confidence interval, DOR diagnostic odds ratio, NGAL neutrophil gelatinase-associated lipocalin, IL-18 interleukin-18, Cr urine creatinine, KIM-1 kidney injury molecule-1, L-FABP liver-type fatty acid-binding protein, 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”