Accuracy of Urine Kidney Injury Molecule-1 in Predicting Acute Kidney Injury in Children; a Systematic Review and Meta-Analysis

Introduction: there is considerable controversy on the accuracy of kidney injurymolecule-1 (kim-1) in prediction of acute kidney injury (aki) in children. therefore, the present study intends to provide a systematic review and meta-analysis of the value of this biomarker in predicting aki in children. methods: an extensive search was performed on the medline, embase, scopus and web of science databases by the end of 2019. cohort and case-control studies on children were included. urinary kim-1 levels were compared between aki and non-aki groups. findings were reported as an overall standardized mean difference (smd) with a 95% confidence interval (ci). also, the overall area under the receiver operating characteristic (roc) curve (auc) of kim-1 in predicting aki in children was calculated. results: data from 13 articles were included. urinary kim-1 levels in children with stage 1 aki were higher than the non-aki group only when assessed within the first 12 hours after admission (smd = 0.95; 95% ci: 0.07 to 1.84; p = 0.034). however, urinary kim-1 levels in children with stage 2-3 aki were significantly higher than non-aki children (p <0.01) at all times. the auc of urinary kim-1 in predicting aki in children was 0.69 (95% ci: 0.62 to 0.77). conclusion: based on the available evidence, kim-1 seems to have moderate value in predicting aki in children. since previous meta-analyses have provided other urinary and serum biomarkers that have better discriminatory accuracy than kim-1, so it had better not to use kim-1 in predicting aki in children.