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Diagnostic accuracy of NT-proBNP to predict the incidence of CSA-AKI: A systematic review and meta-analysis. | LitMetric

AI Article Synopsis

  • CSA-AKI is a serious complication after cardiac surgery, and this study evaluates the effectiveness of NT-proBNP as a diagnostic tool for identifying at-risk patients.
  • Researchers analyzed data from seven studies involving over 37,000 patients, finding that while higher NT-proBNP levels are associated with an increased risk of CSA-AKI, its overall sensitivity and specificity are not adequate for accurate prediction.
  • The conclusion emphasizes the need for better biomarkers for the early detection of CSA-AKI, despite the insights gained on NT-proBNP's limitations.

Article Abstract

Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a severe complication following cardiac surgery. Early identification and diagnosis are critical. In this study, we aim to systematically assess the diagnostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) for CSA-AKI.

Methods: The PubMed, Embase, Web of Science, and Cochrane Library databases were searched from January 1971 to October 2023 to identify prospective observational and retrospective observational studies. Data extraction and study screening were carried out independently by 2 authors. The methodological quality of the included studies was evaluated by the Quality Assessment of Diagnostic Accuracy Studies 2 standards, and all statistical analyses were conducted by Stata 15.0.

Results: Seven studies including 37,200 patients were identified. The pooled sensitivity of 0.67 (95% credible interval [CI] = 0.56-0.77), specificity of 0.55 (95% CI = 0.45-0.64), area under the summary receiver operating characteristic curve of 0.65 (95% CI = 0.60-0.69), positive likelihood ratio of 1.5 (95% CI = 1.2-1.8), negative likelihood ratio of 0.60 (95% CI = 0.46-0.79), and diagnostic odds ratio of 2 (95% CI = 2-4) suggested that patients with higher preoperative NT-proBNP levels (pg/mL) are at higher risk of developing acute kidney injury after cardiac surgery. However, NT-proBNP lacks sufficient sensitivity and specificity to reliably predict CSA-AKI.

Conclusion: Our findings suggest that the diagnostic accuracy of NT-proBNP to predict the incidence of CSA-AKI is limited. However, we provide novel perspectives on the early detection of CSA-AKI biomarkers, and it is urgent to identify more precise and practical biomarkers for the early diagnosis of CSA-AKI.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521026PMC
http://dx.doi.org/10.1097/MD.0000000000039479DOI Listing

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