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The following is a summary of “Combination of urinary biomarkers can predict cardiac surgery-associated acute kidney injury: a systematic review and meta-analysis,” published in the March 2025 issue of Annals of Intensive Care by Kiss et al. 

Researchers conducted a retrospective study to assess the predictive value of urinary biomarkers (UBs) for cardiac surgery (CS)–associated acute kidney injury (AKI) and assess the accuracy of combining these biomarkers in predictive models to aid in early identification.  

They included all clinical studies evaluating the diagnostic accuracy of individual or combined UBs. Searches were conducted in 3 databases (MEDLINE, EMBASE, and CENTRAL) on November 11, 2022, and updated on November 3, 2024, without filters or restrictions. Meta-analysis was performed using random and mixed-effects models. The primary outcome measured the predictive value of each UB at different time points for identifying AKI [Kidney Disease Improving Global Outcomes (KDIGO)]. The secondary outcome assessed the performance of UB combinations and clinical models incorporating UBs. The Area under the receiving operator curve (AUC-ROC) served as the main effect measure.  

The results showed that out of 13,908 screened records, 95 articles (both randomized and non-randomized studies) were included in the analysis. The UBs measured intraoperatively and in the early postoperative period had maximum acceptable predictive value, with the highest AUC values of 0.74 [95% CI 0.68, 0.81], 0.73 [0.65, 0.82], and 0.74 [0.72, 0.77] for severe CS–AKI. For all CS-AKI stages, UBs measured in these periods had AUCs of 0.75 [0.67, 0.82] and 0.73 [0.54, 0.92]. Combining UB measurements improved identification, with AUCs of 0.82 [0.75, 0.88] for all cases and 0.85 [0.79, 0.91] for severe cases of AKI.  

Investigators concluded that the combination of UB measurements led to good accuracy. 

Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-025-01459-7