Urinary Calprotectin for Early Detection of Pediatric Acute Kidney Injury: A Systematic Review and Meta-analysis

Background: The available evidence suggests that urinary calprotectin may be a potential biomarker in distinguishing between intrinsic acute kidney injury (AKI) and prerenal AKI.  Objectives: The aim of this study was to determine the diagnostic value of calprotectin in identifying pediatric acute r...

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Main Authors: Mohammad Mehdi Hashemi, Ayda Dadras, Amirmohammad Toloui, Mohammad Kiah, Behnaz Bazargani, Neamatollah Ataei, Hamzah Adel Ramawad, Mahmoud Yousefifard, Mostafa Hosseini
Format: Article
Language:English
Published: Mazandaran University of Medical Sciences 2024-07-01
Series:Journal of Pediatrics Review
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Online Access:http://jpr.mazums.ac.ir/article-1-602-en.pdf
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author Mohammad Mehdi Hashemi
Ayda Dadras
Amirmohammad Toloui
Mohammad Kiah
Behnaz Bazargani
Neamatollah Ataei
Hamzah Adel Ramawad
Mahmoud Yousefifard
Mostafa Hosseini
author_facet Mohammad Mehdi Hashemi
Ayda Dadras
Amirmohammad Toloui
Mohammad Kiah
Behnaz Bazargani
Neamatollah Ataei
Hamzah Adel Ramawad
Mahmoud Yousefifard
Mostafa Hosseini
author_sort Mohammad Mehdi Hashemi
collection DOAJ
description Background: The available evidence suggests that urinary calprotectin may be a potential biomarker in distinguishing between intrinsic acute kidney injury (AKI) and prerenal AKI.  Objectives: The aim of this study was to determine the diagnostic value of calprotectin in identifying pediatric acute renal impairment.  Methods: A search of the Medline, Embase, Scopus and Web of Science electronic databases was conducted on April 27, 2024. Diagnostic studies conducted on the value of urinary calprotectin in AKI were included. Two independent reviewers assessed the search records and any disagreements were resolved by discussion. The risk of bias was assessed using quality assessment of diagnostic accuracy studies (QUADAS-2) guidelines. The performance of urinary calprotectin in diagnosing AKI and its discriminatory ability between intrinsic and prerenal AKI were evaluated by calculating the pooled standardized mean difference (SMD) and 95% confidence interval (CI), as well as sensitivity, specificity and area under the curve (AUC).  Results: Seven studies were included. The mean urinary levels of calprotectin in AKI were significantly higher than those in the non-AKI group (SMD=0.73; 95% CI, 0.50%, 0.97%; I2=0.00%). The mean urinary levels of calprotectin in pediatrics with intrinsic AKI were significantly higher than in those with prerenal AKI (SMD=0.76; 95% CI, 0.48%, 1.05%; 95% CI, 0%). Urinary calprotectin exhibited a sensitivity of 0.937 (95% CI, 0.829%, 0.978%) and a specificity of 0.252 (95% CI, 0.126%, 0.442%) for distinguishing intrinsic AKI from prerenal AKI. Additionally, the AUC of urinary calprotectin in differentiating intrinsic AKI from prerenal AKI was 0.691 (95% CI, 0.541%, 0.809%).  Conclusions: Urinary calprotectin demonstrates fair screening performance characteristics for differentiating intrinsic from prerenal AKI in children. However, the low specificity necessitates additional diagnostic testing in cases with positive results.
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spelling doaj-art-8ce41a7247a244439b5d891e63510c292024-12-06T07:13:41ZengMazandaran University of Medical SciencesJournal of Pediatrics Review2322-43982322-44012024-07-01123223232Urinary Calprotectin for Early Detection of Pediatric Acute Kidney Injury: A Systematic Review and Meta-analysisMohammad Mehdi Hashemi0Ayda Dadras1Amirmohammad Toloui2Mohammad Kiah3Behnaz Bazargani4Neamatollah Ataei5Hamzah Adel Ramawad6Mahmoud Yousefifard7Mostafa Hosseini8 Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran. Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran. Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran. Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran. Pediatrics Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran. Pediatrics Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran. Department of Emergency Medicine, NYC Health & Hospitals, New York, United States. Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran. Department of Pediatrics, Valiasr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Background: The available evidence suggests that urinary calprotectin may be a potential biomarker in distinguishing between intrinsic acute kidney injury (AKI) and prerenal AKI.  Objectives: The aim of this study was to determine the diagnostic value of calprotectin in identifying pediatric acute renal impairment.  Methods: A search of the Medline, Embase, Scopus and Web of Science electronic databases was conducted on April 27, 2024. Diagnostic studies conducted on the value of urinary calprotectin in AKI were included. Two independent reviewers assessed the search records and any disagreements were resolved by discussion. The risk of bias was assessed using quality assessment of diagnostic accuracy studies (QUADAS-2) guidelines. The performance of urinary calprotectin in diagnosing AKI and its discriminatory ability between intrinsic and prerenal AKI were evaluated by calculating the pooled standardized mean difference (SMD) and 95% confidence interval (CI), as well as sensitivity, specificity and area under the curve (AUC).  Results: Seven studies were included. The mean urinary levels of calprotectin in AKI were significantly higher than those in the non-AKI group (SMD=0.73; 95% CI, 0.50%, 0.97%; I2=0.00%). The mean urinary levels of calprotectin in pediatrics with intrinsic AKI were significantly higher than in those with prerenal AKI (SMD=0.76; 95% CI, 0.48%, 1.05%; 95% CI, 0%). Urinary calprotectin exhibited a sensitivity of 0.937 (95% CI, 0.829%, 0.978%) and a specificity of 0.252 (95% CI, 0.126%, 0.442%) for distinguishing intrinsic AKI from prerenal AKI. Additionally, the AUC of urinary calprotectin in differentiating intrinsic AKI from prerenal AKI was 0.691 (95% CI, 0.541%, 0.809%).  Conclusions: Urinary calprotectin demonstrates fair screening performance characteristics for differentiating intrinsic from prerenal AKI in children. However, the low specificity necessitates additional diagnostic testing in cases with positive results.http://jpr.mazums.ac.ir/article-1-602-en.pdfbiomarkerurinary leveldiagnostic performanceacute kidney injury (aki)
spellingShingle Mohammad Mehdi Hashemi
Ayda Dadras
Amirmohammad Toloui
Mohammad Kiah
Behnaz Bazargani
Neamatollah Ataei
Hamzah Adel Ramawad
Mahmoud Yousefifard
Mostafa Hosseini
Urinary Calprotectin for Early Detection of Pediatric Acute Kidney Injury: A Systematic Review and Meta-analysis
Journal of Pediatrics Review
biomarker
urinary level
diagnostic performance
acute kidney injury (aki)
title Urinary Calprotectin for Early Detection of Pediatric Acute Kidney Injury: A Systematic Review and Meta-analysis
title_full Urinary Calprotectin for Early Detection of Pediatric Acute Kidney Injury: A Systematic Review and Meta-analysis
title_fullStr Urinary Calprotectin for Early Detection of Pediatric Acute Kidney Injury: A Systematic Review and Meta-analysis
title_full_unstemmed Urinary Calprotectin for Early Detection of Pediatric Acute Kidney Injury: A Systematic Review and Meta-analysis
title_short Urinary Calprotectin for Early Detection of Pediatric Acute Kidney Injury: A Systematic Review and Meta-analysis
title_sort urinary calprotectin for early detection of pediatric acute kidney injury a systematic review and meta analysis
topic biomarker
urinary level
diagnostic performance
acute kidney injury (aki)
url http://jpr.mazums.ac.ir/article-1-602-en.pdf
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