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Meta-Analysis
. 2013 Mar;61(3):430-9.
doi: 10.1053/j.ajkd.2012.10.016. Epub 2012 Dec 8.

Performance of urinary liver-type fatty acid-binding protein in acute kidney injury: a meta-analysis

Paweena Susantitaphong  1 , Monchai Siribamrungwong, Kent Doi, Eisei Noiri, Norma Terrin, Bertrand L Jaber
Affiliations
Meta-Analysis

Performance of urinary liver-type fatty acid-binding protein in acute kidney injury: a meta-analysis

Paweena Susantitaphong et al. Am J Kidney Dis. 2013 Mar.

Abstract

Background: Urinary liver-type fatty acid-binding protein (L-FABP) is a proximal tubular injury candidate biomarker for early detection of acute kidney injury (AKI), with variable performance characteristics depending on clinical settings.

Study design: Meta-analysis of diagnostic test studies assessing the performance of urinary L-FABP in AKI.

Setting & population: Literature search in MEDLINE, EMBASE, Scopus, Google Scholar, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov using search terms "liver-type fatty acid-binding protein" and "L-FABP."

Selection criteria for studies: Studies of humans investigating the performance characteristics of urinary L-FABP for the early diagnosis of AKI and AKI-related outcomes, including dialysis requirement and mortality.

Predictor: Urinary L-FABP.

Outcomes: Diagnosis of AKI, dialysis requirement, and in-hospital death.

Results: 15 prospective cohort and 2 case-control studies were identified. Only 7 cohort studies could be meta-analyzed. The estimated sensitivity of urinary L-FABP level for the diagnosis of AKI was 74.5% (95% CI, 60.4%-84.8%), and specificity was 77.6% (95% CI, 61.5%-88.2%). The estimated sensitivity of urinary L-FABP level for predicting dialysis requirement was 69.1% (95% CI, 34.6%-90.5%), and specificity was 42.7% (95% CI, 3.1%-94.5%); for in-hospital mortality, sensitivity and specificity were 93.2% (95% CI, 66.2%-99.0%) and 78.8% (95% CI, 27.0%-97.4%), respectively.

Limitations: Paucity and low quality of studies, different clinical settings, and variable definitions of AKI.

Conclusions: Although urinary L-FABP may be a promising biomarker for early detection of AKI and prediction of dialysis requirement and in-hospital mortality, its potential value needs to be validated in large studies and across a broader spectrum of clinical settings.

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Figures

Figure 1
Figure 1
Study selection flow diagram.
Figure 2
Figure 2
Hierarchical summary receiver operating characteristic curve displaying the performance of urinary liver-type fatty acid–binding protein for the early diagnosis of acute kidney injury (across all clinical settings).
See this image and copyright information in PMC

References

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