Shu Sun1, Zhijia Liu1, Changqing Chen1, Zhisong Wang1, Hailong Jin2, Xiaoyun Meng1, Bing Dai3, Liming Zhang4, Chenchen Zhou5,6, Cheng Xue1,3, Xiang Li1. 1. Department of Urology, The 8th Medical Center of Chinese PLA General Hospital Beijing 100091, China. 2. Organ Transplantation Center, The 3rd Medical Center of Chinese PLA General Hospital Beijing 100039, China. 3. Division of Nephrology, Changzheng Hospital, Second Military Medical University Shanghai 200003, China. 4. Department of Nephrology, Zhabei Central Hospital of Jingan District of Shanghai Shanghai 200000, China. 5. Outpatient Department, Yangpu Third Military Retreat Shanghai 200000, China. 6. Department of Nephrology, Yueyang Hospital Shanghai 200000, China.
Abstract
BACKGROUND: Serum fibroblast growth factor 23 (FGF23) is associated with acute kidney injury (AKI) and mortality in patients with critical illnesses. However, the accurate predictive performance of FGF23 on AKI remains inconclusive. METHODS: Meta-analysis was performed using data sources including PubMed, Web of Science, EMBASE, and Cochrane (until June 1, 2021). Cohort or observational studies including patients with AKI and serum FGF23 level as the index test were included. The primary outcome was the AKI detective accuracy. This study has been registered in PROSPERO (CRD42021249930). RESULTS: Eleven studies with 1946 patients in seven countries were included. Across all settings, the sensitivity and specificity for serum FGF23 levels to predict AKI were 82% (95% CI, 66-91%) and 77% (95% CI, 67-85%), respectively. The diagnostic odds ratio of FGF23 was 15.51 (95% CI, 4.89-49.19), with the pooled positive likelihood ratio of 3.62 (95% CI, 2.25-5.83) and a negative likelihood ratio of 0.23 (95% CI, 0.11-0.50). The area under the receiver operating characteristic curve to detect AKI was 0.86 (95% CI, 0.82-0.88). C-terminal FGF23 had a better performance than intact FGF23. CONCLUSIONS: Plasma FGF23 is a valuable biomarker for incident AKI in critically ill patients. Comparisons of FGF23 with other biomarkers in AKI still need more studies to prove. AJTR
BACKGROUND: Serum fibroblast growth factor 23 (FGF23) is associated with acute kidney injury (AKI) and mortality in patients with critical illnesses. However, the accurate predictive performance of FGF23 on AKI remains inconclusive. METHODS: Meta-analysis was performed using data sources including PubMed, Web of Science, EMBASE, and Cochrane (until June 1, 2021). Cohort or observational studies including patients with AKI and serum FGF23 level as the index test were included. The primary outcome was the AKI detective accuracy. This study has been registered in PROSPERO (CRD42021249930). RESULTS: Eleven studies with 1946 patients in seven countries were included. Across all settings, the sensitivity and specificity for serum FGF23 levels to predict AKI were 82% (95% CI, 66-91%) and 77% (95% CI, 67-85%), respectively. The diagnostic odds ratio of FGF23 was 15.51 (95% CI, 4.89-49.19), with the pooled positive likelihood ratio of 3.62 (95% CI, 2.25-5.83) and a negative likelihood ratio of 0.23 (95% CI, 0.11-0.50). The area under the receiver operating characteristic curve to detect AKI was 0.86 (95% CI, 0.82-0.88). C-terminal FGF23 had a better performance than intact FGF23. CONCLUSIONS: Plasma FGF23 is a valuable biomarker for incident AKI in critically ill patients. Comparisons of FGF23 with other biomarkers in AKI still need more studies to prove. AJTR
Authors: Meredith P Schuh; Edward Nehus; Qing Ma; Christopher Haffner; Michael Bennett; Catherine D Krawczeski; Prasad Devarajan Journal: Am J Kidney Dis Date: 2015-05-29 Impact factor: 8.860
Authors: David E Leaf; Marta Christov; Harald Jüppner; Edward Siew; T Alp Ikizler; Aihua Bian; Guanhua Chen; Venkata S Sabbisetti; Joseph V Bonventre; Xuan Cai; Myles Wolf; Sushrut S Waikar Journal: Kidney Int Date: 2016-02-17 Impact factor: 10.612