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RESEARCH PAPER
A comprehensive review and meta-analysis of suPAR as a predictor of acute kidney injury
1
Medical University, Warsaw, Poland
2
Polish Society of Disaster Medicine, Warsaw, Poland
3
International Academy of Ecology and Medicine, Kyiv, Ukraine
4
Institute of Environmental Protection – National Research Institute, Warsaw, Poland
5
International European University, Kyiv, Ukraine
6
Collegium Medicum, Jan Kochanowski University, Kielce, Poland
7
Baylor College of Medicine, Houston, United States
8
Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
9
Medical University, Lublin, Poland
Ann Agric Environ Med. 2023;30(2):364-368
KEYWORDS
soluble urokinase plasminogen activator receptorsuPARacute kidney injuryacute renal failurebiomarkerpredictionmeta-analysis
TOPICS
Health effects of chemical pollutants in agricultural areas , including occupational and non-occupational effects of agricultural chemicals (pesticides, fertilizers) and effects of industrial disposal (heavy metals, sulphur, etc.) contaminating the atmosphere, soil and waterPrevention of occupational diseases in agriculture, forestry, food industry and wood industryState of the health of rural communities depending on various factors: social factors, accessibility of medical care, etc.
ABSTRACT
Introduction and objective:
The global impact of acute kidney injury (AKI) has not been thoroughly investigated. With the development of new techniques, soluble urokinase plasminogen activator receptor (suPAR) has become increasingly important in the diagnosis of AKI. Therefore, a systematic review and meta-analysis was carried out to evaluate the predictive value of suPAR for AKI.
Material and methods:
The review and meta-analysis investigated the relationship between suPAR levels and acute kidney injury. Pubmed, Scopus, Cochrane Controlled Register of Trials, and Embase were searched for relevant studies from inception to 10 January 2023. Stata (Ver. 16 StataCorp, College Station, TX, USA) was used for all statistical analyses. A random effects model using the Mantel-Haenszel approach was employed, and odds ratios (OR) and standard mean differences (SMD) with 95% confidence intervals (CI) were calculated for binary and continuous outcomes, respectively.
Results:
Nine studies reported suPAR levels among patients with and without AKI. Pooled analysis showed that suPAR levels in patients with and without AKI varied and amounted to 5.23 ± 4.07 vs. 3.23 ±0.67 ng/mL (SMD = 3.19; 95%CI: 2.73 to 3.65; p<0.001). The results from the sensitivity analysis did not alter the direction.
Conclusions:
This results show that increasing suPAR levels are associated with the occurrence of AKI. SuPAR might act as a novel biomarker for CI-AKI in clinical practice.
The global impact of acute kidney injury (AKI) has not been thoroughly investigated. With the development of new techniques, soluble urokinase plasminogen activator receptor (suPAR) has become increasingly important in the diagnosis of AKI. Therefore, a systematic review and meta-analysis was carried out to evaluate the predictive value of suPAR for AKI.
Material and methods:
The review and meta-analysis investigated the relationship between suPAR levels and acute kidney injury. Pubmed, Scopus, Cochrane Controlled Register of Trials, and Embase were searched for relevant studies from inception to 10 January 2023. Stata (Ver. 16 StataCorp, College Station, TX, USA) was used for all statistical analyses. A random effects model using the Mantel-Haenszel approach was employed, and odds ratios (OR) and standard mean differences (SMD) with 95% confidence intervals (CI) were calculated for binary and continuous outcomes, respectively.
Results:
Nine studies reported suPAR levels among patients with and without AKI. Pooled analysis showed that suPAR levels in patients with and without AKI varied and amounted to 5.23 ± 4.07 vs. 3.23 ±0.67 ng/mL (SMD = 3.19; 95%CI: 2.73 to 3.65; p<0.001). The results from the sensitivity analysis did not alter the direction.
Conclusions:
This results show that increasing suPAR levels are associated with the occurrence of AKI. SuPAR might act as a novel biomarker for CI-AKI in clinical practice.
ABBREVIATIONS
AKI – acute kidney injury; ARF – acute renal failure; CI – confidence interval; NGAL – neutrophil gelatinase-associated lipid calin; NOS – Newcastle Ottawa Scale; OR – odds ratio; ROS – reactive oxygen species; SMD – standard mean difference;
suPAR – soluble urokinase plasminogen activator receptor
ACKNOWLEDGEMENTS
The study was financed under the programme of the Ministry of Education and Science in Warsaw in 2019–2023 under the title: ‘Regional Initiative of Excellence’ (Project No. 024/RID/2018/19).
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