Geng Jiwen, Qiu Yuxuan, Qin Zheng, Su Baihai
Department of Nephrology, West China Hospital, Sichuan University, Chengdu, 610041, China.
Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China.
J Transl Med. 2021 Mar 12;19(1):105. doi: 10.1186/s12967-021-02776-8.
The aim of the study was to systematically review relevant studies to evaluate the diagnostic value of urinary kidney injury molecule 1 (uKIM-1) for acute kidney injury (AKI) in adults.
We searched PubMed and Embase for literature published up to November 1st, 2019 and used the Quality Assessment Tool for Diagnosis Accuracy Studies (QUADAS-2) to assess the quality. Then, we extracted useful information from each eligible study and pooled sensitivity, specificity, and area under the curve (AUC) values.
A total of 14 studies with 3300 patients were included. The estimated sensitivity of urinary KIM-1 (uKIM-1) in the diagnosis of AKI was 0.74 (95% CrI 0.62-0.84), and the specificity was 0.84 (95% CrI, 0.76-0.90). The pooled diagnostic odds ratio (DOR) was 15.22 (95% CrI, 6.74-42.20), the RD was 0.55 (95% CrI 0.43-0.70), and the AUC of uKIM-1 in diagnosing AKI was 0.62 (95% CrI 0.41-0.76). The results of the subgroup analysis showed the influence of different factors.
Urinary KIM-1 is a good predictor for AKI in adult patients with relatively high sensitivity and specificity. However, further research and clinical trials are still needed to confirm whether and how uKIM-1 can be commonly used in clinical diagnosis.
本研究旨在系统回顾相关研究，以评估尿肾损伤分子1（uKIM-1）对成人急性肾损伤（AKI）的诊断价值。
我们检索了截至2019年11月1日发表在PubMed和Embase上的文献，并使用诊断准确性研究质量评估工具（QUADAS-2）来评估质量。然后，我们从每项符合条件的研究中提取有用信息，并汇总敏感性、特异性和曲线下面积（AUC）值。
共纳入14项研究，涉及3300例患者。尿KIM-1（uKIM-1）诊断AKI的估计敏感性为0.74（95%可信区间0.62-0.84），特异性为0.84（95%可信区间0.76-0.90）。汇总诊断比值比（DOR）为15.22（95%可信区间6.74-42.20），RD为0.55（95%可信区间0.43-0.70），uKIM-1诊断AKI的AUC为0.62（95%可信区间0.41-0.76）。亚组分析结果显示了不同因素的影响。
尿KIM-1对成年AKI患者是一个具有较高敏感性和特异性的良好预测指标。然而，仍需要进一步的研究和临床试验来证实uKIM-1是否以及如何能够普遍应用于临床诊断。
