Abstract
Background Urinary kidney injury molecule 1 (uKIM-1) is a proximal tubular injury biomarker for predicting acute kidney injury (AKI); its prognostic value varies depending on the clinical and population characteristics. However, the predictive value of uKIM-1 for diagnosis of contrast-induced acute kidney injury (CI-AKI) remains unclear. Method Medline, Embase, ClinicalTrials.gov, Cochrane Library database, and the China National Knowledge Infrastructure (CNKI) were used to identify relevant studies from their inception to November 31, 2019. Studies that met the inclusion criteria were included. Relevant data were extracted to obtain pooled sensitivity (SEN) and specificity (SPE), summary receiver operating characteristic curve (ROC), and area under the ROC (AUC or AUROC). A bivariate mixed-effects regression model was used for data analysis. Results A total of 946 patients from 8 eligible studies were included. Across all the studies, the diagnostic odds ratio (DOR) for uKIM-1 level to predict CI-AKI was 19 (95% CI 10–39), with SEN and SPE of 0.84 and 0.78, respectively. The AUROC for uKIM-1 in predicting CI-AKI was 0.88 (95% CI 0.85–0.90). There was a substantial heterogeneity across the studies (I2 was 37.73% for the summary sensitivity and 69.31% for the summary specificity). Conclusion Urinary KIM-1 has a high predictive value for diagnosis of CI-AKI in patients who have undergone cardiac catheterization.
Highlights
Contrast-induced acute kidney injury (CI-AKI) is a common and serious complication after cardiac catheterization (CC), percutaneous coronary intervention (PCI), and coronary angiography (CAG)
It takes over 24 to 48 hours to diagnose contrast-induced acute kidney injury (CI-AKI) using serum creatinine (sCr), which makes it too late for intervention [4]. us, sCr is believed to be inadequate for the diagnosis of CI-AKI, and there is an urgent need for biomarkers that can detect CI-AKI sooner and more accurately
Relevant articles were identified through a systematic search of PubMed, Medline, Embase, Cochrane Library, ClinicalTrials.gov, and the China National Knowledge Infrastructure (CNKI) databases from their inception to November 31, 2019, with no language restriction. e following search terms were used: (KIM1OR Kidney injury molecule 1 (KIM-1) OR kidney injury molecule 1) AND
Summary
Contrast-induced acute kidney injury (CI-AKI) is a common and serious complication after cardiac catheterization (CC), percutaneous coronary intervention (PCI), and coronary angiography (CAG). It accounts for 12% of all hospital-acquired kidney failure and increases the length of hospitalization, a situation that is worsening with increasing numbers of patients with comorbidities, including those requiring cardiovascular interventional procedures [1]. Urinary kidney injury molecule 1 (uKIM-1) is a proximal tubular injury biomarker for predicting acute kidney injury (AKI); its prognostic value varies depending on the clinical and population characteristics. The predictive value of uKIM-1 for diagnosis of contrast-induced acute kidney injury (CI-AKI) remains unclear. Urinary KIM-1 has a high predictive value for diagnosis of CIAKI in patients who have undergone cardiac catheterization
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