Introduction: The aim of the study was to systematically review relevant studies to evaluate the diagnostic value of urinary kidney injury molecule 1 (uKIM-1) for acute kidney injury (AKI) in adults.
Method: We searched PubMed and Embase for literature published up to November 1st, 2019 and used the Quality Assessment Tool for Diagnosis Accuracy Studies (QUADAS-2) to assess the quality. Then, we extracted useful information from each eligible study and pooled sensitivity, specificity, and area under the curve (AUC) values.
Results: A total of 14 studies with 3300 patients were included. The estimated sensitivity of urinary KIM-1 (uKIM-1) in the diagnosis of AKI was 0.74 (95% CrI 0.62-0.84), and the specificity was 0.84 (95% CrI, 0.76-0.90). The pooled diagnostic odds ratio (DOR) was 15.22 (95% CrI, 6.74-42.20), the RD was 0.55 (95% CrI 0.43-0.70), and the AUC of uKIM-1 in diagnosing AKI was 0.62 (95% CrI 0.41-0.76). The results of the subgroup analysis showed the influence of different factors.
Conclusion: Urinary KIM-1 is a good predictor for AKI in adult patients with relatively high sensitivity and specificity. However, further research and clinical trials are still needed to confirm whether and how uKIM-1 can be commonly used in clinical diagnosis.
Keywords: AKI; Acute kidney injury; KIM-1; Kidney injury molecule 1; Meta-analysis; Systematic review.