Prediction of Acute Kidney Injury by Fibroblast Growth Factor 23 (FGF-23) in Adult Patients, A Meta-analysis Study.

INTRODUCTION: The aim of the current meta-analysis was to assess the predictive value of blood fibroblast growth factor 23 (FGF-23) for acute kidney injury (AKI) in adult patients. METHODS: We retrieved relative publications from electronic databases including the Cochrane Library, PubMed, Google Scholar, Scopus, web of science, and Wanfang Data from their inception to Aug 2022. RESULTS: This meta-analysis study included seven prospective cohort trials comprising 1,655 adult patients. The overall pooled area under the receiver operating characteristic curve (AUC) from seven studies was 0.83 (95% CI: 0.80 to 0.86). Significant heterogeneity was identified (Q = 9.82, P = .004, I2 = 80). Pooled sensitivity and specificity were 0.75 (95% CI: 0.59 to 0.87) and 0.77 (95% CI: 0.65 to 0.87), respectively. Pooled positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 3.3 (95% CI: 1.8 to 6.3), 0.32 (95% CI: 0.16 to 0.63), and 10 (95% CI: 3 to 38); respectively. Moreover, our sensitivity analysis showed that when a trial from Asia was excluded, the predictive value of FGF-23 was declined. CONCLUSION: Our results of meta-analysis of seven prospective cohort trials suggested that blood FGF-23 is a candidate indicator for the prediction of AKI in adult patients. Results of future large and well-designed clinical trials are still needed.  DOI: 10.52547/ijkd.7189.