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Published on: November 27, 2019
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Accuracy of Liver-Type Fatty Acid-Binding Protein in Predicting Acute Kidney Injury: A Meta-Analysis
Ting-Hui Chiang1, Chia-Hung Yo2, Gin Hoong Lee1
1Department of Medicine, National Taiwan University Hospital, Taipei, Taiwan.
The Journal of Applied Laboratory Medicine
|September 9, 2021
Summary
Liver-type fatty acid-binding protein (L-FABP) shows moderate accuracy for predicting acute kidney injury (AKI). This meta-analysis confirms L-FABP
Area of Science:
- Nephrology
- Biomarker Discovery
- Diagnostic Accuracy
Background:
- Liver-type fatty acid-binding protein (L-FABP) is recognized as a potential biomarker for early acute kidney injury (AKI) detection.
- The clinical applicability of L-FABP across diverse patient populations and clinical scenarios requires further investigation.
- This meta-analysis aims to systematically evaluate the diagnostic performance of L-FABP in predicting AKI.
Purpose of the Study:
- To assess the overall diagnostic performance of L-FABP for acute kidney injury prediction.
- To evaluate the consistency of L-FABP performance across various clinical settings and patient groups.
- To compare the diagnostic utility of L-FABP with other established AKI biomarkers like NGAL.
Main Methods:
- A comprehensive literature search was conducted across major databases (MEDLINE, EMBASE, Cochrane Library) using relevant keywords.
- Studies reporting L-FABP measurements for AKI prediction were included, extracting data on study design, patient characteristics, AKI diagnostic criteria, and performance metrics.
- Bivariable meta-analysis models were employed to estimate pooled sensitivity and specificity, with summary ROC curves generated to visualize diagnostic performance.
Main Results:
- The meta-analysis included 27 studies, primarily utilizing urine L-FABP (25 studies) and a smaller number using plasma L-FABP (2 studies).
- Overall pooled sensitivity for L-FABP in AKI prediction was 0.74 (95% CI: 0.69-0.80) and specificity was 0.78 (95% CI: 0.71-0.83).
- L-FABP demonstrated a robust area under the ROC curve of 0.82 (95% CI: 0.79-0.85) across varied settings, including ICU, surgery, and contrast-induced AKI.
Conclusions:
- L-FABP is a clinically valuable biomarker with moderate diagnostic accuracy for AKI in diverse settings.
- Subgroup analysis indicated that L-FABP's discriminative capability is comparable to NGAL, except in pediatric cohorts and post-radiocontrast exposure cases.
- The findings support the utility of L-FABP as an early predictor of AKI, with specific considerations for certain patient populations.
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