Comparison of urine neutrophil gelatinase-associated lipocalin and interleukin-18 in prediction of acute kidney injury in adults

Background: Neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) were considered as the most promising biomarkers in prediction of acute kidney injury (AKI), but the priority of them remains unclear. Methods: Databases of PubMed, Elsevier, Cochrane library, and Web of science were searched until August 23rd, 2017 for studies investigated the diagnostic value of urine NGAL (uNGAL) and urine IL-18 (uIL-18) for AKI in adults. Statistical analysis and investigation of heterogeneity source were using RevMan5.3, MetaDiSc1.40, and Stata14.0. Results: A total of 7 studies were included involving 2315 patients from 7 countries in this article, of whom 443 (19.1%) developed AKI. The present meta-analysis demonstrated that uNGAL was more valuable compare with uIL-18 with effect size of 1.09 (95% CI 1.03-1.15, P=.004) in specificity, but not in sensitivity with effect size of 1.12 (95% CI 0.98-1.29, P=.104). Subgroup analysis presented that research design may be a foundation affecting the diagnostic accuracy of uNGAL and uIL-18 for AKI. No substantial publication bias was found. Conclusions: uNGAL is more specific for prediction of AKI in adults as compared with uIL-18.