Background:
Tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) are recently identified urinary biomarkers of acute kidney injury (AKI) in critically ill patients. Because their predictive accuracies vary widely, a meta-analysis was performed to evaluate the accuracy of previously reported urinary TIMP-2 and IGFBP7 cut-offs for predicting AKI.
Methods:
This meta-analysis was reported following the guideline of PRISMA. Four databases, PubMed, the Cochrane Library, the ISI Web of Knowledge, and Embase, were systematically searched from inception to June 2018 by 2 investigators, who independently selected studies, extracted relevant data, and evaluated study quality. A bivariate model was used to calculate the pooled estimates.
Results:
The search identified 5 studies with 1619 critically ill patients. Urinary TIMP-2 and IGFBP7 cut-off points of 0.3 (ng/ml)
2
/1000 had a sensitivity of 0.89 [95% confidence interval (CI) 0.85–0.93], a specificity of 0.48 (95% CI 0.45–0.51) and a diagnostic odds ratio (DOR) of 8.33 (95% CI 5.55–12.52). The area under the curve (AUC) estimated by the summary receiver operating characteristic (SROC) curve was 0.748. Based on 891 critically ill patients from 4 studies, urinary TIMP-2 and IGFBP7 cut-off points of 2.0 (ng/ml)
2
/1000 had a sensitivity of 0.45 (95% CI 0.37–0.53), a specificity of 0.93 (95% CI 0.91–0.95) and a DOR of 11.43 (95% CI 7.43–17.57). The AUC estimated by SROC was 0.844.
Conclusion:
Cut-off values around 0.3 (ng/ml)
2
/1000 (high sensitivity) and 2.0 (ng/ml)
2
/1000 (high specificity) could be accurate surrogate biomarkers predicting AKI in critically ill patients. The urinary TIMP-2 and IGFBP7 cut-off point of 2.0 (ng/mL)
2
/1000 appears to have the highest overall accuracy.
Trial registration:
PROSPERO registration number 2018: CRD42018084457 Registered on 11 February 2018.
An
unprecedented nickel-catalyzed reductive 1,2-dialkynylation
of alkenes bearing an 8-aminoquinoline directing group has been developed.
This method proceeded through a migratory insertion/reductive-coupling
process under mild conditions with a wide substrate scope and good
functional group tolerance, providing direct access to the synthetically
flexible 1,5-diynes. Moreover, the 1,2-dialkynylation products could
be further converted to borate-ester- or azide-functionalized 1,5-dienes,
ditriazole, β-diyne primary amide, and trisubstituted benzene.
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