尿肾损伤分子-1预测儿童急性肾损伤的准确性：一项系统评价和Meta分析

Accuracy of Urine Kidney Injury Molecule-1 in Predicting Acute Kidney Injury in Children; a Systematic Review and Meta-Analysis.

作者信息

Fazel Mojtaba, Sarveazad Arash, Mohamed Ali Kosar, Yousefifard Mahmoud, Hosseini Mostafa

机构信息

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

Department of Pediatrics, Valiasr Hospital, Imam Khomeini Medical Complex, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Acad Emerg Med. 2020 Apr 5;8(1):e44. eCollection 2020.

INTRODUCTION

There is considerable controversy on the accuracy of Kidney Injury Molecule-1 (KIM-1) in prediction of acute kidney injury (AKI) in children. Therefore, the present study intends to provide a systematic review and meta-analysis of the value of this biomarker in predicting AKI in children.

METHODS

An extensive search was performed on the Medline, Embase, Scopus and Web of Science databases by the end of 2019. Cohort and case-control studies on children were included. Urinary KIM-1 levels were compared between AKI and non-AKI groups. Findings were reported as an overall standardized mean difference (SMD) with a 95% confidence interval (CI). Also, the overall area under the receiver operating characteristic (ROC) curve (AUC) of KIM-1 in predicting AKI in children was calculated.

RESULTS

Data from 13 articles were included. Urinary KIM-1 levels in children with stage 1 AKI were higher than the non-AKI group only when assessed within the first 12 hours after admission (SMD = 0.95; 95% CI: 0.07 to 1.84; p = 0.034). However, urinary KIM-1 levels in children with stage 2-3 AKI were significantly higher than non-AKI children (p <0.01) at all times. The AUC of urinary KIM-1 in predicting AKI in children was 0.69 (95% CI: 0.62 to 0.77).

CONCLUSION

Based on the available evidence, KIM-1 seems to have moderate value in predicting AKI in children. Since previous meta-analyses have provided other urinary and serum biomarkers that have better discriminatory accuracy than KIM-1, so it had better not to use KIM-1 in predicting AKI in children.

引言

关于肾损伤分子-1（KIM-1）在预测儿童急性肾损伤（AKI）方面的准确性存在相当大的争议。因此，本研究旨在对该生物标志物在预测儿童AKI中的价值进行系统评价和荟萃分析。

方法

截至2019年底，对Medline、Embase、Scopus和Web of Science数据库进行了广泛检索。纳入关于儿童的队列研究和病例对照研究。比较AKI组和非AKI组的尿KIM-1水平。研究结果以总体标准化均值差（SMD）及95%置信区间（CI）报告。此外，计算了KIM-1在预测儿童AKI时的总体受试者工作特征（ROC）曲线下面积（AUC）。

结果

纳入13篇文章的数据。仅在入院后12小时内评估时，1期AKI儿童的尿KIM-1水平高于非AKI组（SMD = 0.95；95%CI：0.07至1.84；p = 0.034）。然而，2-3期AKI儿童的尿KIM-1水平在所有时间均显著高于非AKI儿童（p <0.01）。尿KIM-1预测儿童AKI的AUC为0.69（95%CI：0.62至0.77）。