Abstract
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.
Highlights
Acute kidney injury (AKI) is a common and widespread problem with high mortality and morbidity
Our findings can be summarized in the following points: (1) Urinary calprotectin is a good marker for differentiation of intrinsic and prerenal acute kidney injury (AKI); (2) the diagnostic performance of urinary calprotectin is not significantly different in different acute kidney diagnostic criteria and in adult or pediatric populations
It may be reasonable to conclude that urinary calprotectin is a good diagnostic test in the discrimination of an intrinsic kidney injury with a pooled diagnostic accuracy of symmetric SROC of 0.9667
Summary
Acute kidney injury (AKI) is a common and widespread problem with high mortality and morbidity. Many studies have revealed that neutrophil gelatinase-associated lipocalin (NGAL) has shown promising results in the early diagnosis of AKI [1,2,3,4], distinguishing between prerenal and intrinsic kidney injury Urinary calprotectin is a novel biomarker that distinguishes between intrinsic or prerenal acute kidney injury (AKI) in different studies. 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. The pooled positive likelihood ratio (LR) was 15.15, and the negative LR was 0.11
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