Chang Gung University College of Medicine, Taoyuan, Taiwan.
Division of Nephrology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, 222 Mai-Jin Road, Keelung, 204, Taiwan.
Crit Care. 2023 Aug 18;27(1):318. doi: 10.1186/s13054-023-04610-7.
Urinary C-C motif chemokine ligand 14 (CCL14) has been described as an effective marker for delayed recovery of acute kidney injury (AKI), yet its efficacy has been found to vary between different trials. The goal of this research was to assess the predictive performance of urinary CCL14 as a marker for persistent AKI.
In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the PubMed, Embase, and Cochrane databases up to April 2023 for studies of adults (> 18 years) that reported the diagnostic performance of urinary CCL14. The sensitivity, specificity, number of events, true positive, and false positive results were extracted and evaluated. Hierarchical summary receiver operating characteristic curves (HSROCs) were used to summarize the pooled test performance, and the Grading of Recommendations, Assessment, Development and Evaluations criteria were used to appraise the quality of evidence.
We included six studies with 952 patients in this meta-analysis. The occurrence of persistent AKI among these patients was 39.6% (377/952). The pooled sensitivity and specificity results of urinary CCL14 in predicting persistent AKI were 0.81 (95% CI 0.72-0.87) and 0.71 (95% CI 0.53-0.84), respectively. The pooled positive likelihood ratio (LR) was 2.75 (95% CI 1.63-4.66), and the negative LR was 0.27 (95% CI 0.18-0.41). The HSROC with pooled diagnostic accuracy was 0.84.
Our results suggest that urinary CCL14 can be used as an effective marker for predicting persistent AKI.
尿 C-C 基序趋化因子配体 14(CCL14)已被描述为急性肾损伤(AKI)延迟恢复的有效标志物,但不同试验发现其疗效存在差异。本研究旨在评估尿 CCL14 作为持续性 AKI 标志物的预测性能。
根据系统评价和荟萃分析的首选报告项目(PRISMA)指南,我们检索了 PubMed、Embase 和 Cochrane 数据库,截至 2023 年 4 月,检索了关于成人(>18 岁)尿液 CCL14 诊断性能的研究。提取并评估了灵敏度、特异性、事件数量、真阳性和假阳性结果。分层综合接收者操作特征曲线(HSROCs)用于总结汇总测试性能,使用推荐评估、制定与评价分级标准评估证据质量。
我们纳入了这项荟萃分析中的 6 项研究,共 952 名患者。这些患者持续性 AKI 的发生率为 39.6%(377/952)。尿 CCL14 预测持续性 AKI 的汇总灵敏度和特异性结果分别为 0.81(95%CI 0.72-0.87)和 0.71(95%CI 0.53-0.84)。汇总阳性似然比(LR)为 2.75(95%CI 1.63-4.66),阴性 LR 为 0.27(95%CI 0.18-0.41)。具有汇总诊断准确性的 HSROC 为 0.84。
我们的结果表明,尿 CCL14 可用作预测持续性 AKI 的有效标志物。