Table 6.
Summary of the diagnostic meta-analysis for the studies using standard AKI criteria (any of RIFLE, AKIN, and KDIGO)
| 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) |
|---|---|---|---|---|---|---|---|
| NGAL | 33 | 75.9 (71.2–80.0) | 79.9 (76.0–83.3) | 12.5 (9.2–16.9) | Reference | Reference | Reference |
| IL-18 | 11 | 66.2 (58.9–72.8) | 79.8 (75.7–83.4) | 7.7 (5.3–11.2) | 0.87 (0.79–0.96)* | 1.00 (0.98–1.02) | 0.62 (0.45–0.85)* |
| IL-18/Cr | 3 | 71.4 (62.8–78.6) | 80.1 (74.3–84.9) | 10.0 (6.1–16.5) | 0.94 (0.84–1.05) | 1.00 (0.95–1.06) | 0.80 (0.50–1.29) |
| KIM-1 | 12 | 76.2 (70.2–81.4) | 80.0 (75.6–83.7) | 12.8 (8.7–18.7) | 1.01 (0.94–1.08) | 1.00 (0.97–1.03) | 1.03 (0.74–1.42) |
| KIM-1/Cr | 6 | 69.3 (59.5–77.5) | 83.4 (78.3–87.5) | 11.3 (6.7–19.1) | 0.91 (0.80–1.04) | 1.04 (1.00–1.09) | 0.91 (0.55–1.50) |
| L-FABP | 9 | 70.4 (62.6–77.1) | 81.7 (77.7–85.2) | 10.6 (7.0–16.1) | 0.93 (0.84–1.02) | 1.02 (1.00–1.05) | 0.85 (0.59–1.22) |
| L-FABP/Cr | 8 | 81.9 (74.2–87.7) | 70.0 (59.0–79.1) | 10.6 (5.6–20.1) | 1.08 (0.99–1.18) | 0.88 (0.76–1.01) | 0.85 (0.44–1.63) |
| NGAL/Cr | 9 | 71.1 (63.0–78.1) | 86.2 (82.1–89.5) | 15.4 (9.6–24.4) | 0.94 (0.85–1.04) | 1.08 (1.04–1.12)* | 1.23 (0.79–1.91) |
| Serum NGAL | 35 | 74.3 (69.4–78.8) | 78.9 (74.8–82.5) | 10.8 (7.9–14.8) | 0.98 (0.92–1.04) | 0.99 (0.96–1.01) | 0.87 (0.65–1.15) |
| TIMP-2 × IGFBP-7: custom | 6 | 85.9 (74.4–92.7) | 58.1 (43.6–71.4) | 8.4 (3.4–20.7) | 1.13 (1.00–1.28)* | 0.73 (0.57–0.93)* | 0.67 (0.26–1.75) |
| TIMP-2 × IGFBP-7: 0.3 | 16 | 66.6 (56.7–75.2) | 74.0 (64.5–81.7) | 5.7 (3.2–10.0) | 0.88 (0.75–1.02) | 0.93 (0.82–1.05) | 0.46 (0.24–0.86)* |
| TIMP-2 × IGFBP-7: 2 | 10 | 17.5 (11.6–25.6) | 97.5 (95.8–98.5) | 8.3 (4.2–16.1) | 0.23 (0.15–0.35) | 1.22 (1.16–1.28) | 0.66 (0.32–1.38) |
AKI acute kidney injury, RIFLE Risk, Injury, Failure, Loss, and End-stage renal disease, AKIN Acute Kidney Injury Network, KDIGO Kidney Disease Improving Global Outcomes, 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”