Clinical Utility Of NGAL In Predicting Delayed Graft Function Among Patients With Renal Transplantation:a Meta-analysis

Objective:The predictive value of NGAL level for delayed graft function after kidney transplantation remains unclear,To access the early diagnosis value of neutrophil gelatinase-associated lipocalin(NGAL)in renal transplantation with delayed graft function(DGF)by a Meta analysis.Methods:Search the databases such as,Embase,Pubmed,Cochrane Library,China Biology Medicine disc and so on with compute,which were published before march2018.The literatures were screened according to the criterias of inclusion and exclusion,then the data were extracted from the qualified literature.All qualified literatures were assessed by the methodological quality tool of Quality Assessment of Diagnostic Accuracy Studies(QUADAS).Meta-analyses were performed in MetaDisc 1.4 according to the characteristics of heterogeneity.Result:In total 90 relevant studies were searched.of which 11 were enrolled and 811 patients were included,while 275 patients develop AKI.The polled Sensitivity 0.76(95%CI:0.70-0.81),The polled Specificity were 0.86(95%CI:0.83-0.89),THE polled Positive likelihood ratio were 5.57(95%CI:3.60-8.59),The polled negative likelihood ratio were 0.27(95%CI : 0.22-0.34),The polled diagnostic odds ratio31.14(95%CI:13.88-69.86),and The polled AUC of SROC was 0.8995(SE:0.0269).Subgroup analysis revealed the polled sensitivity,specificity,positive likelih-ood ratio,negative likelihood ratio,and diagnostic odds ratio of urinary NGAL were0.73(95%CI:0.67-0.79),0.87(95%CI:0.83-0.90),6.47(95%CI:3.45-12.12),0.31(95%CI:0.24-0.42),31.25(95%CI:11.46-85.22),and the AUC of SROC was 0.8707(SE:0.0411).The sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,and diagnostic odds ratio of serum NGAL were 0.88(95%CI:0.75-0.96),0.81(95%CI:0.73-0.88),4.49(95%CI:2.96-6.83),0.17(95%CI:0.07-0.41),30.37(95%CI:11.04-83.58),and the area under the SROC was 0.8618(SE:0.0640).Conclusions:1.NGAL as an novel biomarker for early prediction DGF in renal transpla-ntation.2.The diagnosis accuracy of Urinary NGAL is higher than plasma NGAL on the early diagnosis and prediction of DGF in renal transplantation.