Urinary kidney injury molecule-1 as a diagnostic biomarker for persistent severe acute kidney injury: a systematic review and Bayesian meta-analysis
- 1Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37, Guoxue lane, Wuhou District, Chengdu, Sichuan Province 610041 China
Abstract
Background: Despite the vast amount of literature dedicated to biomarkers and acute kidney injury (AKI), the persistent state of AKI has been relatively neglected. The objective of this study was to systematically review relevant studies and evaluate the diagnostic value of urinary kidney injury molecule 1 (uKIM-1) for persistent severe AKI in adults.
Methods: We searched the PubMed, Web of Science, Embase, the Cochrane Library, and ClinicalTrials databases up to December 2025. Eligible studies included adult patients and assessed the diagnostic value of uKIM-1 for persistent severe AKI. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used for quality assessment. Pooled sensitivity, specificity, area under the curve (AUC) and diagnostic odds ratio (DOR) values were calculated via a Bayesian bivariate diagnostic meta-analysis model.
Results: Eight studies with 2349 patients were selected for meta-analysis. 378 patients were diagnosed with persistent severe AKI. The included studies were published between 2011 and 2025 and involved heterogeneous clinical settings, including intensive care, emergency department, postoperative, sepsis, COVID-19, and liver transplantation populations. The estimated sensitivity of uKIM-1 was 0.67 (95% CrI, 0.59–0.75), and the specificity was 0.73 (95% CrI, 0.61–0.84). The pooled DOR was 5.91 (95% CrI, 2.91–11.20), and the AUC was 0.75 (95% CrI, 0.62–0.84). Sensitivity analyses using alternative cutoff selections and prior specifications showed generally stable estimates.
Conclusion: This Bayesian meta-analysis indicates that uKIM-1 has moderate diagnostic value for persistent severe AKI in adults. Current evidence does not support its use as a standalone biomarker, and future studies should evaluate its incremental value in combination with other biomarkers and clinical variables.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12882-026-05209-0.
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BibTeX
@article{an2026urinary,
title = {{Urinary kidney injury molecule-1 as a diagnostic biomarker for persistent severe acute kidney injury: a systematic review and Bayesian meta-analysis}},
author = {Xinqi An and Jiwen Geng and Kaixin Lei and Baihai Su},
journal = {BMC Nephrology},
year = {2026},
month = aug,
doi = {10.1186/s12882-026-05209-0},
url = {https://doi.org/10.1186/s12882-026-05209-0},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Urinary kidney injury molecule-1 as a diagnostic biomarker for persistent severe acute kidney injury: a systematic review and Bayesian meta-analysis
AU - Xinqi An
AU - Jiwen Geng
AU - Kaixin Lei
AU - Baihai Su
PY - 2026
DA - 2026/08/05
JO - BMC Nephrology
DO - 10.1186/s12882-026-05209-0
UR - https://doi.org/10.1186/s12882-026-05209-0
AB - Background: Despite the vast amount of literature dedicated to biomarkers and acute kidney injury (AKI), the persistent state of AKI has been relatively neglected. The objective of this study was to systematically review relevant studies and evaluate the diagnostic value of urinary kidney injury molecule 1 (uKIM-1) for persistent severe AKI in adults. Methods: We searched the PubMed, Web of Science, Embase, the Cochrane Library, and ClinicalTrials databases up to December 2025. Eligible studies included adult patients and assessed the diagnostic value of uKIM-1 for persistent severe AKI. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used for quality assessment. Pooled sensitivity, specificity, area under the curve (AUC) and diagnostic odds ratio (DOR) values were calculated via a Bayesian bivariate diagnostic meta-analysis model. Results: Eight studies with 2349 patients were selected for meta-analysis. 378 patients were diagnosed with persistent severe AKI. The included studies were published between 2011 and 2025 and involved heterogeneous clinical settings, including intensive care, emergency department, postoperative, sepsis, COVID-19, and liver transplantation populations. The estimated sensitivity of uKIM-1 was 0.67 (95% CrI, 0.59–0.75), and the specificity was 0.73 (95% CrI, 0.61–0.84). The pooled DOR was 5.91 (95% CrI, 2.91–11.20), and the AUC was 0.75 (95% CrI, 0.62–0.84). Sensitivity analyses using alternative cutoff selections and prior specifications showed generally stable estimates. Conclusion: This Bayesian meta-analysis indicates that uKIM-1 has moderate diagnostic value for persistent severe AKI in adults. Current evidence does not support its use as a standalone biomarker, and future studies should evaluate its incremental value in combination with other biomarkers and clinical variables. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12882-026-05209-0.
SN - 1471-2369
ER -