{
  "abstract": "Introduction: In addition to serum creatinine (SCr), a kidney functional biomarker, structural damage biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL) may improve identification of patients at risk of adverse outcomes after cardiac surgery. Previous meta-analyses have relied on study-level data, functional acute kidney injury (AKI) definitions and heterogeneous NGAL cut-off concentrations, limiting comparability and clinical interpretation.\n\nMethods and analysis: We will conduct an individual patient data (IPD) meta-analysis of prospective studies investigating NGAL in adult patients undergoing cardiac surgery. Authors of eligible studies will be contacted to provide IPD according to a prespecified data request form. Primary outcomes will be the AKI incidence, initiation of renal replacement therapy and in-hospital mortality after surgery. SCr and NGAL will be analysed both as continuous predictors and using study-specific as well as harmonised IPD-derived cut-off values to characterise AKI phenotypes and predictors of adverse outcomes enabling the quantification of risk across the full spectrum of NGAL and SCr concentrations.\n\nExploratory analyses using mixed-effects logistic regression models will investigate patient-level characteristics that may modify clinical risk for the development of AKI and related adverse outcomes. The study results will be reported in accordance with the Preferred Reporting Items for a Systematic Review and Meta-Analysis of Individual Participant Data. The findings may improve biomarker-guided risk stratification after cardiac surgery.\n\nEthics and dissemination: Ethics approval was obtained for all included studies by the respective ethics committees or institutional review boards. This meta-analysis is exempt from additional ethical approval because it uses anonymised data from previously published studies with informed consent already obtained. Findings will be disseminated through national and international conferences and may be published in separate peer-reviewed articles according to the scope of the analyses.\n\nPROSPERO registration number: CRD420261336943.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nephrology, Central Clinic Bad Berka, Bad Berka, Germany",
    "Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany",
    "University Clinic for Cardiology and Angiology, Otto von Guericke University Magdeburg, Magdeburg, Germany",
    "Department of Neonatology, Charité University Medicine Berlin, Berlin, Germany",
    "University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA",
    "University of Otago Christchurch, Department of Medicine, Christchurch, New Zealand",
    "UNAM Sapientiam University La Sapienza and Great Health Science, Rome, Italy",
    "Department of Laboratory Medicine, Konkuk University, Gwangjin-gu, Seoul, Republic of Korea",
    "Dongnam Institute of Radiological & Medical Sciences, Konkuk University, Gwangjin-gu, Seoul, Republic of Korea",
    "Otto von Guericke University Magdeburg, Medical Faculty, Magdeburg, Germany",
    "Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany",
    "Department of Cardiology, Immanuel Diakonie Bernau, Bernau, Germany",
    "Institute of Social Medicine and Health Systems Research, Otto von Guericke University Magdeburg, Magdeburg, Germany",
    "Department of Nephrology, Prince of Wales Hospital and Clinical School, University of New South Wales, Sydney, New South Wales, Australia",
    "Department of Emergency and Critical Care Medicine, The University of Tokyo, Bunkyo, Japan",
    "Division of Nephrology, Washington University in St. Louis, St. Louis, Missouri, USA",
    "Laboratorio Clinico, Centro Cardiologico Monzino IRCCS, Milano, Italy",
    "Department of Anesthesiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain",
    "Department of Anaesthesiology, Resuscitation and Intensive Care, Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia",
    "Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Astana, Kazakhstan",
    "Department of Cardiology and Intensive Care Medicine, Central Clinic Bad Berka, Bad Berka, Germany",
    "Philipps University of Marburg, Medical Faculty, Marburg, Germany",
    "Department of Cardiac Surgery, Central Clinic Bad Berka, Bad Berka, Germany",
    "Department of Surgical Sciences, Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden",
    "Department of Nephrology and Hypertension, University Clinic Erlangen of Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany",
    "Department of Cardiac Surgery, Pomeranian Medical University, Szczecin, Poland"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 31,
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        0
      ],
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      "orcid": "0000-0002-5611-1506"
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        3
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      "name": "John Pickering",
      "orcid": "0000-0001-9475-0344"
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        6
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      "name": "Salvatore Di Somma"
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        7
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      "name": "Mina Hur",
      "orcid": "0000-0002-4429-9978"
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        7
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      "name": "Hanah Kim"
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      "name": "Chul Min Park"
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        9,
        10
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      "name": "Michael Haase"
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        11,
        12
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      "name": "Anja Haase-Fielitz"
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    {
      "affs": [
        13
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      "name": "Zoltan H. Endre"
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    {
      "affs": [
        14
      ],
      "name": "Kent Doi"
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    {
      "affs": [
        14,
        15
      ],
      "name": "Yohei Komaru"
    },
    {
      "affs": [
        16
      ],
      "name": "Giovanni Introcaso"
    },
    {
      "affs": [
        17
      ],
      "name": "Mercedes García Álvarez",
      "orcid": "0000-0002-8884-7796"
    },
    {
      "affs": [
        18
      ],
      "name": "Suzana Bojic"
    },
    {
      "affs": [
        19
      ],
      "name": "Abdushappar Gaipov"
    },
    {
      "affs": [
        2
      ],
      "name": "Sebastian Lange"
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    {
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        20,
        21
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      "name": "Philipp Lauten"
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    {
      "affs": [
        20
      ],
      "name": "Lisa C. Costello-Boerrigter"
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    {
      "affs": [
        22
      ],
      "name": "Sabine Bleiziffer",
      "orcid": "0000-0001-9669-7372"
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    {
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        23
      ],
      "name": "Miklos Lipcsey",
      "orcid": "0000-0002-1976-4129"
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    {
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        24
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      "name": "Gunnar Schley",
      "orcid": "0000-0001-9929-5854"
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      "name": "Philipp Stieger"
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      "name": "Jakub Udzik"
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      "name": "Tomasz Wróblewski",
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      "name": "Antonia Zapf",
      "orcid": "0000-0002-8467-0508"
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      "name": "Rüdiger C. Braun-Dullaeus"
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        0,
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      "name": "Christian Albert",
      "orcid": "0000-0002-6956-9962"
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  "doi": "10.1136/bmjopen-2026-124451",
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      "heading",
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      "heading",
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    [
      "openalex",
      "2727|Acute Kidney Injury Research"
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  "pmcid": "PMC13723849",
  "pmid": "42946360",
  "published": "2026-10-27",
  "publisher": "BMJ",
  "ris": "https://research.draconitic.com/paper/epn7706n1s72a.ris",
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      "first_seen": "2026-10-30T12:19:44Z",
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  "subjects": [
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      "field": "medicine",
      "origin": "heading:Cardiovascular Medicine",
      "subfield": "cardiovascular"
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  ],
  "title": "Protocol for an individual patient data meta-analysis for the assessment of risk factors affecting the development and outcome of functional and structural acute kidney injury after cardiac surgery: the METARIS CS-AKI study",
  "title_text": "Protocol for an individual patient data meta-analysis for the assessment of risk factors affecting the development and outcome of functional and structural acute kidney injury after cardiac surgery: the METARIS CS-AKI study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:35Z",
  "url": "https://research.draconitic.com/paper/epn7706n1s72a",
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