尿肾损伤分子 1 对心脏导管检查后造影剂诱导急性肾损伤的诊断预测价值：一项荟萃分析。
The Predictive Value of Urinary Kidney Injury Molecular 1 for the Diagnosis of Contrast-Induced Acute Kidney Injury after Cardiac Catheterization: A Meta-Analysis.
机构信息
Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
Department of Nephrology, Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany.
出版信息
J Interv Cardiol. 2020 Aug 13;2020:4982987. doi: 10.1155/2020/4982987. eCollection 2020.
BACKGROUND
Urinary kidney injury molecule 1 (uKIM-1) is a proximal tubular injury biomarker for predicting acute kidney injury (AKI); its prognostic value varies depending on the clinical and population characteristics. However, the predictive value of uKIM-1 for diagnosis of contrast-induced acute kidney injury (CI-AKI) remains unclear.
METHOD
Medline, Embase, ClinicalTrials.gov, Cochrane Library database, and the China National Knowledge Infrastructure (CNKI) were used to identify relevant studies from their inception to November 31, 2019. Studies that met the inclusion criteria were included. Relevant data were extracted to obtain pooled sensitivity (SEN) and specificity (SPE), summary receiver operating characteristic curve (ROC), and area under the ROC (AUC or AUROC). A bivariate mixed-effects regression model was used for data analysis.
RESULTS
A total of 946 patients from 8 eligible studies were included. Across all the studies, the diagnostic odds ratio (DOR) for uKIM-1 level to predict CI-AKI was 19 (95% CI 10-39), with SEN and SPE of 0.84 and 0.78, respectively. The AUROC for uKIM-1 in predicting CI-AKI was 0.88 (95% CI 0.85-0.90). There was a substantial heterogeneity across the studies ( was 37.73% for the summary sensitivity and 69.31% for the summary specificity).
CONCLUSION
Urinary KIM-1 has a high predictive value for diagnosis of CI-AKI in patients who have undergone cardiac catheterization.
背景
尿肾损伤分子 1（uKIM-1）是预测急性肾损伤（AKI）的近端肾小管损伤生物标志物；其预后价值取决于临床和人群特征。然而，uKIM-1 对造影剂诱导的急性肾损伤（CI-AKI）的预测价值尚不清楚。
方法
检索 Medline、Embase、ClinicalTrials.gov、Cochrane 图书馆数据库和中国知网（CNKI），从建库至 2019 年 11 月 31 日，收集符合纳入标准的相关研究。提取相关数据，获得汇总敏感度（SEN）和特异性（SPE）、汇总受试者工作特征曲线（ROC）和 ROC 曲线下面积（AUC 或 AUROC）。采用双变量混合效应回归模型进行数据分析。
结果
纳入 8 项研究的 946 例患者。所有研究中，uKIM-1 水平预测 CI-AKI 的诊断比值比（DOR）为 19（95%CI 10-39），SEN 和 SPE 分别为 0.84 和 0.78。uKIM-1 预测 CI-AKI 的 AUROC 为 0.88（95%CI 0.85-0.90）。研究间存在较大异质性（汇总敏感度的 为 37.73%，汇总特异性的 为 69.31%）。
结论
尿 KIM-1 对接受心脏导管检查的患者 CI-AKI 具有较高的诊断价值。
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