Diagnostic Value of Urine Tissue Inhibitor of Metalloproteinase-2 and Insulin-Like Growth Factor-Binding Protein 7 for Acute Kidney Injury: A Meta-Analysis

PLoS One. 2017 Jan 20;12(1):e0170214. doi: 10.1371/journal.pone.0170214. eCollection 2017.

Abstract

Background: Tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein-7 (IGFBP7) are both involved in renal tubular epithelial cell cycle arrest in acute kidney injury (AKI). Several recent studies showed that urine TIMP-2 times IGFBP7 ([TIMP-2]*[IGFBP7]) is a promising biomarker to predict AKI.

Methods: The aim of this meta-analysis was to assess the diagnostic value of urine [TIMP-2]*[IGFBP7] for early diagnosis of AKI. Relevant studies were retrieved from the PubMed, EMBASE, and Cochrane Library databases. The sensitivity and specificity were determined, and summary receiver operating characteristic (SROC) curves were constructed.

Results: Ten full-text prospective studies were included in this meta-analysis. The estimated sensitivity of urine [TIMP-2]*[IGFBP7] for the early diagnosis of AKI was 0.84 (95% CI = 0.80-0.88) and the specificity was 0.57 (95%CI = 0.55-0.60). The SROC analysis showed an area under the curve of 0.8813.

Limitation: The limited number of included studies, small sample size, unpublished negative results and language limitation might have affected the evaluation.

Conclusion: Urine [TIMP-2]*[IGFBP7] is a promising candidate for early detection of AKI, especially in ruling-out AKI. However, the potential of this biomarker should be validated in larger studies with a broader spectrum of clinical settings.

Publication types

  • Meta-Analysis

MeSH terms

  • Acute Kidney Injury / diagnosis*
  • Acute Kidney Injury / urine
  • Humans
  • Insulin-Like Growth Factor Binding Proteins / urine*
  • Prospective Studies
  • ROC Curve
  • Tissue Inhibitor of Metalloproteinase-2 / urine*

Substances

  • Insulin-Like Growth Factor Binding Proteins
  • TIMP2 protein, human
  • insulin-like growth factor binding protein-related protein 1
  • Tissue Inhibitor of Metalloproteinase-2

Grants and funding

This work was supported by a special clinical medicine research funds from the Chinese Medical Association (14050370574, XL), grant from medical scientific research projects of Chongqing Municipal Health and Family Planning Commission (20142031, XL), Natural Science Foundation Project of CQ CSTC(cstc2015jcyjA10069), and the found for fostering talents in scientific research of Chongqing Medical University (201404, XL), the same as Funding Information. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.