肾绞痛指数预测儿童急性肾损伤的鉴别精度：一项系统评价与荟萃分析

Discriminatory Precision of Renal Angina Index in Predicting Acute Kidney Injury in Children; a Systematic Review and Meta-Analysis.

作者信息

Abbasi Arash, Mehdipour Rabori Pardis, Farajollahi Ramtin, Mohammed Ali Kosar, Ataei Nematollah, Yousefifard Mahmoud, Hosseini Mostafa

机构信息

Pediatric Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Pediatrics, Division of Nephrology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Acad Emerg Med. 2020 Mar 26;8(1):e39. eCollection 2020.

INTRODUCTION

There is still controversy over the value of renal angina index (RAI) in predicting acute renal failure (AKI) in children. Therefore, the present study aims to provide evidence by conducting a systematic review and meta-analysis on the value of RAI in this regard.

METHODS

An extensive search of Medline, Embase, Scopus and Web of Science databases was conducted by the end of January 2020 using words related to RAI and AKI. Two independent reviewers screened and summarized the related studies. Data were analysed using STATA 14.0 statistical program and discriminatory precision of RAI was assessed.

RESULTS

Data from 11 studies were included. These studies included data from 3701 children (60.41% boys). There were 752 children with AKI and 2949 non-AKI children. Pooled analysis showed that the area under the ROC curve of RAI in prediction of AKI was 0.88 [95% confidence interval (CI): 0.85 to 0.91]. Sensitivity and specificity of this tool in predicting AKI were 0.85% (95% CI: 0.74% to 0.92%) and 0.79% (95% CI: 0.69% to 0.89%), respectively. The diagnostic odds ratio of RAI was 20.40 (95% CI: 9.62 to 43.25).

CONCLUSION

The findings of the present meta-analysis showed that RAI is a reliable tool in predicting AKI in children.

引言

肾绞痛指数（RAI）在预测儿童急性肾衰竭（AKI）方面的价值仍存在争议。因此，本研究旨在通过对RAI在这方面的价值进行系统评价和荟萃分析来提供证据。

方法

截至2020年1月，使用与RAI和AKI相关的词汇对Medline、Embase、Scopus和Web of Science数据库进行了广泛检索。两名独立的评审员筛选并总结了相关研究。使用STATA 14.0统计程序分析数据，并评估RAI的鉴别精度。

结果

纳入了11项研究的数据。这些研究包括来自3701名儿童的数据（60.41%为男孩）。有752名AKI儿童和2949名非AKI儿童。汇总分析显示，RAI预测AKI的ROC曲线下面积为0.88[95%置信区间（CI）：0.85至0.91]。该工具预测AKI的敏感性和特异性分别为0.85%（95%CI：0.74%至0.92%）和0.79%（95%CI：0.69%至0.89%）。RAI的诊断比值比为20.40（95%CI：9.62至43.25）。