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Reliability of neutrophil gelatinase-associated lipocalin in detecting acute tubular necrosis in decompensated cirrhosis:Systematic review and meta-analysis

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World Journal of Hepatology 2024年第11期16卷 1331-1338页

作者： Nirav Agrawal Scarlet Louis-Jean Zoya Ladiwala Harsha Adnani Ayesha Kamal Mitchell Karpman Albert Steven Fleisher sanmeet singh Department of Internal Medicine Anne Arundel Medical CenterAnnapolisMD 21401United States Department of Biostatistics Anne Arundel Medical CenterAnnapolisMD 21401United States Department of Gastroenterology Anne Arundel Medical CenterAnnapolisMD 21401United States

BACKGROUND Acute kidney injury(AKI)in cirrhosis is *** diagnosis of AKI in cirrhosis patients depends on clinical presentation and laboratory tests like serum ***,urine biomarkers could also be used to assess the type of AKI and the severity of the *** performed a systematic review with metaanalysis to evaluate the association with urine neutrophil gelatinase-associated lipocalin(NGAL)marker in identifying acute tubular necrosis(ATN)in patients with *** To assess the reliability of urine NGAL in the detection of ATN in patients with *** We systematically searched MEDLINE and PubMed using keywords including“urine biomarkers”,“NGAL”,“kidney dysfunction”,and“cirrhosis”to identify relevant *** was screened and *** studies assessed hospitalized cirrhosis patients with AKI using the urine NGAL *** synthesized the data using diagnostic odds ratio(DOR),comparative and descriptive analyses,and Cochran Mantel-Haenszel(CMH)statistics to evaluate *** Three thousand seven hundred and one patients with cirrhosis were analyzed from a total of 21 cohort *** DOR of 14 of those studies[pooled DOR:22.150,(95%CI:17.58-27.89),P<0.0001]demonstrated a significant association between urine NGAL levels and its identification of *** stratification by cirrhosis status,heterogeneity was analyzed and showed a significant non-zero correlation between NGAL and AKI(CMH statistic=702.19,P<0.0001).CONCLUSION In patients with cirrhosis,the use of urine NGAL is a reliable biomarker for detecting ATN and identifying the etiology of AKI.

关键词： Neutrophil gelatinase-associated lipocalin Acute tubular necrosis Acute kidney injury Cirrhosis Biomarker Severe liver dysfunction

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