Table 7.
Summary of the diagnostic meta-analysis according to AKI criteria with or without UO
| 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) |
|---|---|---|---|---|---|---|---|
| Non-UO | |||||||
| NGAL | 27 | 81.1 (76.6–84.9) | 81.3 (77.2–84.7) | 18.6 (12.8–27.0) | Reference | Reference | Reference |
| IL-18 | 9 | 63.7 (55.1–71.6) | 80.1 (75.5–84.1) | 7.1 (4.5–11.2) | 0.79 (0.70–0.89)* | 0.99 (0.96–1.02) | 0.38 (0.26–0.56)* |
| IL-18/Cr | 3 | 72.4 (63.8–79.6) | 81.0 (75.2–85.7) | 11.2 (6.6–19.0) | 0.89 (0.80–0.99)* | 1.00 (0.95–1.05) | 0.60 (0.37–0.98)* |
| KIM-1 | 12 | 73.8 (67.0–79.7) | 80.1 (75.4–84.0) | 11.3 (7.3–17.5) | 0.91 (0.84–0.99)* | 0.99 (0.96–1.01) | 0.61 (0.42–0.88)* |
| KIM-1/Cr | 6 | 70.8 (61.2–78.8) | 84.1 (79.0–88.2) | 12.8 (7.3–22.3) | 0.87 (0.77–0.99)* | 1.04 (0.99–1.08) | 0.69 (0.41–1.16) |
| L-FABP | 9 | 72.2 (64.2–79.0) | 81.2 (76.7–85.0) | 11.2 (7.0–18.0) | 0.89 (0.81–0.98)* | 1.00 (0.97–1.03) | 0.61 (0.41–0.88)* |
| L-FABP/Cr | 6 | 80.3 (70.4–87.4) | 74.8 (59.4–85.8) | 12.1 (4.9–29.7) | 0.99 (0.89–1.11) | 0.92 (0.77–1.10) | 0.65 (0.26–1.64) |
| NGAL/Cr | 9 | 72.9 (65.0–79.6) | 86.8 (82.6–90.0) | 17.6 (10.7–29.1) | 0.90 (0.82–0.99)* | 1.07 (1.03–1.11)* | 0.95 (0.60–1.50) |
| Serum NGAL | 34 | 79.0 (74.3–83.1) | 79.5 (75.1–83.3) | 14.6 (10.0–21.2) | 0.97 (0.92–1.03) | 0.98 (0.95–1.01) | 0.78 (0.56–1.09) |
| TIMP-2 × IGFBP-7: 0.3 | 5 | 82.2 (67.8–91.0) | 61.8 (41.3–78.9) | 7.5 (2.3–24.6) | 1.01 (0.87–1.18) | 0.76 (0.55–1.05) | 0.40 (0.12–1.40) |
| TIMP-2 × IGFBP-7: 2 | 5 | 25.4 (13.7–42.2) | 95.3 (89.4–98.0) | 6.8 (2.1–22.8) | 0.31 (0.18–0.55)* | 1.17 (1.10–1.25)* | 0.37 (0.10–1.30) |
| UO | |||||||
| NGAL | 7 | 68.2 (54.7–79.2) | 78.5 (67.8–86.3) | 7.8 (4.6–13.1) | Reference | Reference | Reference |
| IL-18 | 2 | 77.4 (62.9–87.4) | 79.3 (68.5–87.1) | 13.1 (6.7–25.7) | 1.14 (0.98–1.31) | 1.01 (0.97–1.05) | 1.68 (0.94–3.01) |
| KIM-1 | 2 | 84.9 (71.6–92.6) | 72.2 (55.1–84.6) | 14.6 (5.9–35.9) | 1.25 (1.08–1.44)* | 0.92 (0.79–1.08) | 1.87 (0.81–4.31) |
| L-FABP/Cr | 2 | 70.4 (38.1–90.2) | 77.5 (46.5–93.2) | 8.2 (2.4–28.2) | 1.03 (0.67–1.60) | 0.99 (0.71–1.38) | 1.05 (0.27–4.02) |
| Serum NGAL | 6 | 67.8 (53.3–79.6) | 79.2 (68.6–86.8) | 8.0 (4.5–14.1) | 1.00 (0.83–1.19) | 1.01 (0.97–1.05) | 1.03 (0.57–1.84) |
| TIMP-2 × IGFBP-7: custom | 5 | 88.2 (76.1–94.6) | 55.8 (39.1–71.2) | 9.5 (4.0–22.6) | 1.29 (1.05–1.60)* | 0.71 (0.52–0.98)* | 1.21 (0.44–3.36) |
| TIMP-2 × IGFBP-7: 0.3 | 12 | 59.0 (46.3–70.6) | 77.2 (66.8–85.1) | 4.9 (3.0–7.9) | 0.87 (0.65–1.14) | 0.98 (0.83–1.16) | 0.63 (0.31–1.27) |
| TIMP-2 × IGFBP-7: 2 | 6 | 16.7 (9.6–27.4) | 98.4 (96.5–99.3) | 12.0 (5.2–27.8) | 0.24 (0.14–0.43)* | 1.25 (1.11–1.41)* | 1.54 (0.57–4.13) |
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, UO urine output
*Numbers in bold indicate significant difference (P < 0.05) versus the referent category: “NGAL”