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Background <p>Despite the vast amount of literature dedicated to biomarkers and acute kidney injury (AKI), the persistent state of AKI has been relatively neglected. The objective of this study was to systematically review relevant studies and evaluate the diagnostic value of urinary kidney injury molecule 1 (uKIM-1) for persistent severe AKI in adults.</p> Methods <p>We searched the PubMed, Web of Science, Embase, the Cochrane Library, and ClinicalTrials databases up to December 2025. Eligible studies included adult patients and assessed the diagnostic value of uKIM-1 for persistent severe AKI. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used for quality assessment. Pooled sensitivity, specificity, area under the curve (AUC) and diagnostic odds ratio (DOR) values were calculated via a Bayesian bivariate diagnostic meta-analysis model.</p> Results <p>Eight studies with 2349 patients were selected for meta-analysis. 378 patients were diagnosed with persistent severe AKI. The included studies were published between 2011 and 2025 and involved heterogeneous clinical settings, including intensive care, emergency department, postoperative, sepsis, COVID-19, and liver transplantation populations. The estimated sensitivity of uKIM-1 was 0.67 (95% CrI, 0.59–0.75), and the specificity was 0.73 (95% CrI, 0.61–0.84). The pooled DOR was 5.91 (95% CrI, 2.91–11.20), and the AUC was 0.75 (95% CrI, 0.62–0.84). Sensitivity analyses using alternative cutoff selections and prior specifications showed generally stable estimates.</p> Conclusion <p>This Bayesian meta-analysis indicates that uKIM-1 has moderate diagnostic value for persistent severe AKI in adults. Current evidence does not support its use as a standalone biomarker, and future studies should evaluate its incremental value in combination with other biomarkers and clinical variables.</p>

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Urinary kidney injury molecule-1 as a diagnostic biomarker for persistent severe acute kidney injury: a systematic review and Bayesian meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月5日

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  • Xinqi An,
  • Jiwen Geng,
  • Kaixin Lei,
  • Baihai Su

摘要

Background

Despite the vast amount of literature dedicated to biomarkers and acute kidney injury (AKI), the persistent state of AKI has been relatively neglected. The objective of this study was to systematically review relevant studies and evaluate the diagnostic value of urinary kidney injury molecule 1 (uKIM-1) for persistent severe AKI in adults.

Methods

We searched the PubMed, Web of Science, Embase, the Cochrane Library, and ClinicalTrials databases up to December 2025. Eligible studies included adult patients and assessed the diagnostic value of uKIM-1 for persistent severe AKI. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used for quality assessment. Pooled sensitivity, specificity, area under the curve (AUC) and diagnostic odds ratio (DOR) values were calculated via a Bayesian bivariate diagnostic meta-analysis model.

Results

Eight studies with 2349 patients were selected for meta-analysis. 378 patients were diagnosed with persistent severe AKI. The included studies were published between 2011 and 2025 and involved heterogeneous clinical settings, including intensive care, emergency department, postoperative, sepsis, COVID-19, and liver transplantation populations. The estimated sensitivity of uKIM-1 was 0.67 (95% CrI, 0.59–0.75), and the specificity was 0.73 (95% CrI, 0.61–0.84). The pooled DOR was 5.91 (95% CrI, 2.91–11.20), and the AUC was 0.75 (95% CrI, 0.62–0.84). Sensitivity analyses using alternative cutoff selections and prior specifications showed generally stable estimates.

Conclusion

This Bayesian meta-analysis indicates that uKIM-1 has moderate diagnostic value for persistent severe AKI in adults. Current evidence does not support its use as a standalone biomarker, and future studies should evaluate its incremental value in combination with other biomarkers and clinical variables.