title: Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials.
abstract: The role of serum cystatin C (Scys) for the detection of acute kidney injury (AKI) has not been fully discussed. This meta-analysis was aimed to investigate the overall diagnostic accuracy of Scys for AKI in adults, and further identify factors affecting its performance. Studies before Sept. 2016 were retrieved from PubMed, Embase, Web of Science and the Cochrane Library. A total of 30 prospective cohort studies (involving 4247 adults from 15 countries, 982 patients occurring AKI) were included. The revised Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) tools demonstrated no significant bias had influenced the methodological quality of the included studies. Scys showed a high predictive power for all-cause AKI, that the area under the receiver operating characteristic curve was 0.89. The detailed assessment parameters, such as sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for Scys were 0.82, 0.82, 4.6, 0.22 and 21, respectively. Although Scys could be slightly influenced by the following factors: settings, AKI diagnostic criteria, ethnicity, determination method, age and gender, these factors above did not reach statistically significance. In conclusion, Scys could be a vital promising marker to screen out AKI.
authors.affiliation: Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu, P.R. China.
authors.forename: Zhenzhu
authors.initials: Z
authors.lastname: Yong
authors.affiliation: Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu, P.R. China.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Pei
authors.affiliation: Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu, P.R. China.
authors.forename: Bei
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu, P.R. China.
authors.forename: Haichuan
authors.initials: H
authors.lastname: Yuan
authors.affiliation: Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu, P.R. China.
authors.forename: Weihong
authors.initials: W
authors.lastname: Zhao
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D055316:Cystatin C / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D044967:Serum / Q000737:chemistry*
chemical_list: D055316:Cystatin C