Neutrophil Gelatinase-associated Lipocalin in the Prediction of Contrast-induced Nephropathy: A Systemic Review and Meta-analysis.
OBJECTIVE
The aim of this study was to investigate the predictive value of neutrophil gelatinase-associated lipocalin (NGAL) in the early diagnosis of contrast-induced nephropathy (CIN).


METHODS
We searched MEDLINE and Embase until December 2014 for articles evaluating the diagnostic accuracy of plasma/serum and urinary NGAL levels to predict CIN. The primary analysis was based on a hierarchical, bivariate, generalized, linear, mixed model. Diagnostic odds ratio (DOR) and sample size-weighted area under the curve for the receiver operating characteristic (AUROC) were calculated.


RESULTS
Ten studies involving 1310 patients were analyzed. Overall, the DOR/AUROC for NGAL level to predict CIN was 20.56 [95% confidence interval (CI), 9.67-43.74]/0.87 (95% CI, 0.84-0.90), with sensitivity and specificity of 0.80 (95% CI, 0.74-0.85) and 0.83 (95% CI, 0.73-0.90), respectively. Subgroup analysis showed that the diagnostic performance of the DOR/AUROC of urinary NGAL [29.48 (95% CI, 12.19-71.27)/0.87 (95% CI, 0.84-0.90)] was better than that of plasma/serum NGAL [14.63 (95% CI, 4.51-47.38)/0.85 (95% CI, 0.82-0.88)] (DOR, P = 0.005, and AUROC, P = 0.04, respectively).


CONCLUSIONS
Plasma/serum and urinary NGAL levels seem to be useful biomarkers in the early prediction of CIN. Moreover, urinary NGAL levels perform better than plasma/serum NGAL.
*Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, China; †Department of Comprehensive Evaluation, Medical Association of Guangdong Province, Guangzhou, China; and ‡Department of Nephrology, Guangzhou First People's Hospital, Guangzhou, China.
Junrong
J
Tong
Hong
H
Li
Hong
H
Zhang
Zhengmao
Z
Luo
Yuanhang
Y
Huang
Jun
J
Huang
Feng
F
He
Junzhou
J
Fu
D058186:Acute Kidney Injury / Q000097:blood* / Q000139:chemically induced / Q000209:etiology / Q000652:urine*; D000209:Acute-Phase Proteins / Q000652:urine*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003287:Contrast Media / Q000009:adverse effects*; D042241:Early Diagnosis; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood* / Q000652:urine*; D011237:Predictive Value of Tests; D011518:Proto-Oncogene Proteins / Q000097:blood* / Q000652:urine*
D000209:Acute-Phase Proteins; D015415:Biomarkers; D003287:Contrast Media; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins