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Accuracy of neutrophil gelatinase-associated lipocalin for acute kidney injury diagnosis in children: systematic review and meta-analysis

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Abstract

Objective

To estimate the accuracy of Neutrophil Gelatinase-Associated Lipocalin (NGAL) as a biomarker for acute kidney injury (AKI) in children.

Methods

A systematic review of the literature was performed. The review protocol was registered at PROSPERO (CRD 42015024153). We conducted searches in the following databases: Medline (PubMed), LILACS (BVS), SCOPUS (Elsevier), Embase (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), Biomed Central, and ISI Web of Science, from January 1990 to October 2016. For inclusion, studies measured NGAL levels in plasma and urine for AKI in children. For each study, 2 × 2 contingency tables were developed. For statistical analysis we calculated the sensitivity, specificity and diagnostic odds ratio. For methodological assessment, we used Quality Assessment of Diagnostic Accuracy Studies–2. Software used for analysis was Stata 14, and RevMan 5.3.

Results

In total 13 studies were analyzed, which included 1629 children. For urinary NGAL, the pooled sensitivity was 0.76 (95% CI 0.62–0.85) and a pooled specificity 0.93 (95% CI 0.88–0.96). The diagnostic odds ratio (DOR) for the detection of AKI was 43 (95% CI 16–115) and the Area under the curve (AUC) was 0.94 (95% CI 0.92–0.96). For plasma NGAL the combined sensitivity was 0.80 (95% CI 0.64–0.90) and a combined specificity was 0.87 (95% CI 0.74–0.94). The DOR was 26 (95% CI 8.0–82) and AUC was 0.90 (95% CI 0.87–0.94) for the detection of AKI in children.

Conclusion

The data suggest that NGAL levels can be an important biomarker for the early detection of AKI in children.

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Acknowledgements

This review was funded by FAPESC (Santa Catarina State Foundation for Research).

Contribution to authorship

LTF, AJG, TC, ESPD and MIR designed the study. LTF, MIR, and ESPD selected included studies and evaluated their quality. AJG derived or calculated diagnostic parameters. All authors made substantial contributions to data interpretation and writing the first draft of the manuscript. LTF, AJG, TC, ESPD, and MIR critically revised the manuscript and approved the final version for publication.

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Authors and Affiliations

  1. Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, Bairro Universitário, Criciúma, SC, CEP: 88806-000, Brazil

    Luís Taddeo Filho, Antonio Jose Grande, Tamy Colonetti, Éverton Simon Possamai Della & Maria Inês da Rosa

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  1. Luís Taddeo Filho
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  2. Antonio Jose Grande
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Correspondence to Antonio Jose Grande.

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No ethical approval is necessary due to its exclusive use of secondary data.

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The authors declare that they have no conflict of interest.

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Filho, L.T., Grande, A.J., Colonetti, T. et al. Accuracy of neutrophil gelatinase-associated lipocalin for acute kidney injury diagnosis in children: systematic review and meta-analysis. Pediatr Nephrol 32, 1979–1988 (2017). https://doi.org/10.1007/s00467-017-3704-6

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  • DOI: https://doi.org/10.1007/s00467-017-3704-6

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