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2017 ; 96
(27
): e7484
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The diagnostic accuracy of urinary TIMP-2 · IGFBP7 for acute kidney injury in
adults: A PRISMA-compliant meta-analysis
#MMPMID28682920
Liu C
; Lu X
; Mao Z
; Kang H
; Liu H
; Pan L
; Hu J
; Wang L
; Zhou F
Medicine (Baltimore)
2017[Jul]; 96
(27
): e7484
PMID28682920
show ga
INTRODUCTION: Early diagnosis of acute kidney injury (AKI) remains a challenge.
Recently, [TIMP-2]·[IGFBP7], which is a combination of urine tissue inhibitor of
metalloproteinase 2 (TIMP-2) and insulin-like growth factor (IGF) binding protein
7 (IGFBP7), has been identified as a potential biomarker of AKI. We performed
this meta-analysis to assess the diagnostic accuracy of urinary [TIMP-2]·[IGFBP7]
for AKI in adult patients. METHODS: We searched the PubMed, Embase, and Cochrane
Library databases from database inception to March 2017. Two authors
independently screened articles based on inclusion and exclusion criteria and
assessed the methodological quality of each included study using the Quality
Assessment of Diagnostic Accuracy Studies 2 criteria. Review Manager and STATA
were used for all statistical analyses. RESULTS: Nine studies (n?=?1886)
satisfied the inclusion criteria. Pooled analyses demonstrated that urinary
[TIMP-2]·[IGFBP7] exhibited fair diagnostic accuracy for AKI (sensitivity [SEN]
0.83 [95% CI 0.75-0.89], specificity [SPE] 0.72 [95% CI 0.56-0.84], and area
under the summary receiver operating characteristic [SROC] curve 0.86 [95% CI
0.82-0.88]) and AKI stage???2 (according to the 2012 Kidney Disease: Improving
Global Outcomes [KDIGO] 2012 classification system; SEN 0.92 [95% CI 0.81-0.96],
SPE 0.63 [95% CI 0.49-0.74], and area under the SROC curve 0.88 [95% CI
0.85-0.91]) in adult patients. CONCLUSION: Our findings indicate that urinary
[TIMP-2]·[IGFBP7] may be a reliable biomarker for the early detection of AKI.
However, given the significant heterogeneity among the included studies,
clinicians should be aware of the utility and limitations of this biomarker in
clinical practice. Additional high-quality studies examining a larger sample of
patients are required.
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