Is plasma neutrophil gelatinase-associated lipocalin a predictive biomarker for acute kidney injury in sepsis patients? A systematic review and meta-analysis

Sollip Kim, Hyun Jung Kim, Hyeong Sik Ahn, Ji Yang Song, Tae Hyun Um, Chong Rae Cho, Hoon Jung, Hyeon Kyoung Koo, Joo Hyun Park, Sung Soon Lee, Hye Kyeong Park

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: Neutrophil gelatinase-associated lipocalin (NGAL) is a useful biomarker for early diagnosis of acute kidney injury (AKI). However, the diagnostic value of NGAL for predicting AKI in sepsis patients is unclear. Methods: MEDLINE, EMBASE, and Cochrane Library databases were searched to identify research publications. Results: Twelve studies from 9 countries including a total of 1582 patients, of whom 315 (19.9%) developed AKI, were included in the study; plasma NGAL levels were significantly higher in adult sepsis patients with AKI than in those without AKI (mean difference, 274.65; 95% confidence interval [CI], 106.16-443.15; I2 = 94%). Urine NGAL levels were not significantly different. The diagnostic odds ratio of plasma NGAL for predicting AKI in sepsis patients was 6.64 (95% CI, 3.80-11.58). The diagnostic accuracy of plasma NGAL was 0.881 (95% CI, 0.819-0.923) for sensitivity, 0.474 (95% CI, 0.367-0.582) for specificity, 0.216 (95% CI, 0.177-0.261) for positive predictive value and 0.965 (95% CI, 0.945-0.977) for negative predictive value. Conclusion: Plasma NGAL has a high sensitivity and a high negative predictive value for detection of AKI in adult sepsis patients. However, its low specificity and low positive predictive value could limit its clinical utility. The usefulness of urine NGAL was not revealed in this study.

Original languageEnglish
Pages (from-to)213-223
Number of pages11
JournalJournal of Critical Care
Volume33
DOIs
Publication statusPublished - 2016 Jun 1

Fingerprint

Acute Kidney Injury
Meta-Analysis
Sepsis
Biomarkers
Confidence Intervals
Urine
Lipocalin-2
MEDLINE
Libraries
Publications
Early Diagnosis
Odds Ratio
Databases
Research

Keywords

  • Acute kidney injury
  • Meta-analysis
  • Neutrophil gelatinase-associated lipocalin (NGAL)
  • Plasma NGAL
  • Sepsis
  • Urine NGAL

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Is plasma neutrophil gelatinase-associated lipocalin a predictive biomarker for acute kidney injury in sepsis patients? A systematic review and meta-analysis. / Kim, Sollip; Kim, Hyun Jung; Ahn, Hyeong Sik; Song, Ji Yang; Um, Tae Hyun; Cho, Chong Rae; Jung, Hoon; Koo, Hyeon Kyoung; Park, Joo Hyun; Lee, Sung Soon; Park, Hye Kyeong.

In: Journal of Critical Care, Vol. 33, 01.06.2016, p. 213-223.

Research output: Contribution to journalArticle

Kim, Sollip ; Kim, Hyun Jung ; Ahn, Hyeong Sik ; Song, Ji Yang ; Um, Tae Hyun ; Cho, Chong Rae ; Jung, Hoon ; Koo, Hyeon Kyoung ; Park, Joo Hyun ; Lee, Sung Soon ; Park, Hye Kyeong. / Is plasma neutrophil gelatinase-associated lipocalin a predictive biomarker for acute kidney injury in sepsis patients? A systematic review and meta-analysis. In: Journal of Critical Care. 2016 ; Vol. 33. pp. 213-223.
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abstract = "Purpose: Neutrophil gelatinase-associated lipocalin (NGAL) is a useful biomarker for early diagnosis of acute kidney injury (AKI). However, the diagnostic value of NGAL for predicting AKI in sepsis patients is unclear. Methods: MEDLINE, EMBASE, and Cochrane Library databases were searched to identify research publications. Results: Twelve studies from 9 countries including a total of 1582 patients, of whom 315 (19.9{\%}) developed AKI, were included in the study; plasma NGAL levels were significantly higher in adult sepsis patients with AKI than in those without AKI (mean difference, 274.65; 95{\%} confidence interval [CI], 106.16-443.15; I2 = 94{\%}). Urine NGAL levels were not significantly different. The diagnostic odds ratio of plasma NGAL for predicting AKI in sepsis patients was 6.64 (95{\%} CI, 3.80-11.58). The diagnostic accuracy of plasma NGAL was 0.881 (95{\%} CI, 0.819-0.923) for sensitivity, 0.474 (95{\%} CI, 0.367-0.582) for specificity, 0.216 (95{\%} CI, 0.177-0.261) for positive predictive value and 0.965 (95{\%} CI, 0.945-0.977) for negative predictive value. Conclusion: Plasma NGAL has a high sensitivity and a high negative predictive value for detection of AKI in adult sepsis patients. However, its low specificity and low positive predictive value could limit its clinical utility. The usefulness of urine NGAL was not revealed in this study.",
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AU - Kim, Sollip

AU - Kim, Hyun Jung

AU - Ahn, Hyeong Sik

AU - Song, Ji Yang

AU - Um, Tae Hyun

AU - Cho, Chong Rae

AU - Jung, Hoon

AU - Koo, Hyeon Kyoung

AU - Park, Joo Hyun

AU - Lee, Sung Soon

AU - Park, Hye Kyeong

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Purpose: Neutrophil gelatinase-associated lipocalin (NGAL) is a useful biomarker for early diagnosis of acute kidney injury (AKI). However, the diagnostic value of NGAL for predicting AKI in sepsis patients is unclear. Methods: MEDLINE, EMBASE, and Cochrane Library databases were searched to identify research publications. Results: Twelve studies from 9 countries including a total of 1582 patients, of whom 315 (19.9%) developed AKI, were included in the study; plasma NGAL levels were significantly higher in adult sepsis patients with AKI than in those without AKI (mean difference, 274.65; 95% confidence interval [CI], 106.16-443.15; I2 = 94%). Urine NGAL levels were not significantly different. The diagnostic odds ratio of plasma NGAL for predicting AKI in sepsis patients was 6.64 (95% CI, 3.80-11.58). The diagnostic accuracy of plasma NGAL was 0.881 (95% CI, 0.819-0.923) for sensitivity, 0.474 (95% CI, 0.367-0.582) for specificity, 0.216 (95% CI, 0.177-0.261) for positive predictive value and 0.965 (95% CI, 0.945-0.977) for negative predictive value. Conclusion: Plasma NGAL has a high sensitivity and a high negative predictive value for detection of AKI in adult sepsis patients. However, its low specificity and low positive predictive value could limit its clinical utility. The usefulness of urine NGAL was not revealed in this study.

AB - Purpose: Neutrophil gelatinase-associated lipocalin (NGAL) is a useful biomarker for early diagnosis of acute kidney injury (AKI). However, the diagnostic value of NGAL for predicting AKI in sepsis patients is unclear. Methods: MEDLINE, EMBASE, and Cochrane Library databases were searched to identify research publications. Results: Twelve studies from 9 countries including a total of 1582 patients, of whom 315 (19.9%) developed AKI, were included in the study; plasma NGAL levels were significantly higher in adult sepsis patients with AKI than in those without AKI (mean difference, 274.65; 95% confidence interval [CI], 106.16-443.15; I2 = 94%). Urine NGAL levels were not significantly different. The diagnostic odds ratio of plasma NGAL for predicting AKI in sepsis patients was 6.64 (95% CI, 3.80-11.58). The diagnostic accuracy of plasma NGAL was 0.881 (95% CI, 0.819-0.923) for sensitivity, 0.474 (95% CI, 0.367-0.582) for specificity, 0.216 (95% CI, 0.177-0.261) for positive predictive value and 0.965 (95% CI, 0.945-0.977) for negative predictive value. Conclusion: Plasma NGAL has a high sensitivity and a high negative predictive value for detection of AKI in adult sepsis patients. However, its low specificity and low positive predictive value could limit its clinical utility. The usefulness of urine NGAL was not revealed in this study.

KW - Acute kidney injury

KW - Meta-analysis

KW - Neutrophil gelatinase-associated lipocalin (NGAL)

KW - Plasma NGAL

KW - Sepsis

KW - Urine NGAL

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