Comparison of urine and blood NGAL for early prediction of delayed graft function in adult kidney transplant recipients: a meta-analysis of observational studies
Comparison of urine and blood NGAL for early prediction of delayed graft function in adult kidney transplant recipients: a meta-analysis of observational studies
复制标题
尿液和血液 NGAL 的比较对成人肾移植受者移植物功能延迟的早期预测：观察性研究的荟萃分析
DOI：
10.1186/s12882-019-1491-y
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发表时间：
2019-08-02
期刊：
影响因子：
2.3
通讯作者：
Shi, Yun Ying
中科院分区：
文献类型：
--
作者：
Li, Ya Mei;Li, Yi;Shi, Yun Ying
中性粒细胞明胶酶相关脂蛋白(NGAL)是早期预测肾移植受者移植延迟功能(DGF)的一种有前景的近端肾小管损伤生物标志物。然而，它在尿液和血液中的预测值在不同的研究中是不同的。我们通过Meta分析比较尿NGAL(UNGAL)和血NGAL(BNGAL)对成人肾移植受者DGF的预测价值。方法系统地检索Medline、Cochrane图书馆和Embase，从最初到2018年5月的相关研究。综合受试者工作特征(SROC)曲线、合并敏感度、特异度和诊断优势比(DOR)评价uNGAL和bNGAL对DGF的预测效果。8篇研究集中在尿中的NGAL，6篇报道了血清或血浆中的NGAL。24 患者ROC下综合面积(AUC)为0.91(95%CI，0.89~0.94)，总的DOR为2 4.17(95%CI，9.94~5 8.75)，敏感性为0.88(95%CI，0.75~0.94)，特异性为0.81(95%CI，0.68~0.89)。24 h NGAL的综合AUC为0.95(95%CI，0.93~0.97)，总的DOR为43.11(95%CI，16.43~113.12)，敏感性为0.91(95%CI，0.81~0.96)，特异性为0.86(95%CI，0.78~0.92)。结论尿和血清/血浆NGAL是肾移植术后早期诊断 的有价值的生物标志物。此外，bNGAL对DGF的早期预测优于uNGAL。
BackgroundNeutrophil gelatinase-assoicated lipocalin (NGAL) appears to be a promising proximal tubular injury biomarker for early prediction of delayed graft function (DGF) in kidney transplant recipients. However, its predictive values in urine and blood were varied among different studies. Here, we performed the meta-analysis to compare the predictive values of urine NGAL (uNGAL) and blood NGAL (bNGAL) for DGF in adult kidney transplant recipients.MethodsWe systematically searched Medline, Cochrane library and Embase for relevant studies from inception to May 2018. The summary receiver operating characteristic (SROC) curves, the pooled sensitivity, specificity and diagnostic odds ratio (DOR) were used to evaluate the prognostic performance of uNGAL and bNGAL for the identification of DGF.ResultsA total of 1036 patients from 14 eligible studies were included in the analysis. 8 studies focused on NGAL in urine and 6 reported NGAL in serum or plasma. The composite area under the ROC (AUC) for 24 h uNGAL was 0.91 (95% CI, 0.89–0.94) and the overall DOR for 24 h uNGAL was 24.17(95% CI, 9.94–58.75) with a sensitivity of 0.88 (95% CI, 0.75–0.94) and a specificity of 0.81 (95% CI, 0.68–0.89). The composite AUC for 24 h bNGAL was 0.95 (95% CI, 0.93–0.97) and the overall DOR for 24 h bNGAL was 43.11 (95% CI, 16.43–113.12) with a sensitivity of 0.91 (95% CI, 0.81–0.96) and a specificity of 0.86 (95% CI, 0.78–0.92).ConclusionsUrine and serum/plasma NGAL were valuable biomarkers for early identification of DGF in kidney transplantation. In addition, the bNGAL was superior to uNGAL in early prediction of DGF.