Key result
Urinary calprotectin demonstrated high diagnostic accuracy for discriminating intrinsic from prerenal acute kidney injury, with a pooled sensitivity of 0.90, specificity of 0.93, and SROC of 0.9667.
Why the study?
Studies assessing urinary calprotectin to distinguish intrinsic from prerenal acute kidney injury were based on varying populations and AKI criteria.
Does urinary calprotectin accurately discriminate between intrinsic and prerenal acute kidney injury?
Meta-Analysis (n=502)
Does urinary calprotectin accurately discriminate between intrinsic and prerenal acute kidney injury?
Effect estimate: SROC 0.9667
Urinary calprotectin demonstrates high diagnostic accuracy for distinguishing intrinsic from prerenal acute kidney injury across different AKI criteria and age groups.
Supports clinical use of urinary calprotectin for AKI differentiation; confirms high accuracy across criteria and populations.
Background: Urinary calprotectin is a novel biomarker that distinguishes between intrinsic or prerenal acute kidney injury (AKI) in different studies. However, these studies were based on different populations and different AKI criteria. We evaluated the diagnostic accuracy of urinary calprotectin and compared its diagnostic performance in different AKI criteria and study populations. Method: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Embase, and the Cochrane database up to September 2018. The diagnostic performance of urinary calprotectin (sensitivity, specificity, predictive ratio, and cutoff point) was extracted and evaluated. Result: This study included six studies with a total of 502 patients. The pooled sensitivity and specificity were 0.90 and 0.93, respectively. The pooled positive likelihood ratio (LR) was 15.15, and the negative LR was 0.11. The symmetric summary receiver operating characteristic (symmetric SROC) with pooled diagnostic accuracy was 0.9667. The relative diagnostic odds ratio (RDOC) of the adult to pediatric population and RDOCs of different acute kidney injury criteria showed no significant difference in their diagnostic accuracy. Conclusion: Urinary calprotectin is a good diagnostic tool for the discrimination of intrinsic and prerenal AKI under careful inspection after exclusion of urinary tract infection and urogenital malignancies. Its performance is not affected by different AKI criteria and adult or pediatric populations.
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Chen et al. (2019) conducted a meta-analysis in Acute kidney injury (n=502). Urinary calprotectin was evaluated on Diagnostic accuracy (sensitivity, specificity, predictive ratio, and cutoff point) (SROC 0.9667). Urinary calprotectin demonstrated high diagnostic accuracy for discriminating intrinsic from prerenal acute kidney injury, with a pooled sensitivity of 0.90, specificity of 0.93, and SROC of 0.9667.
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