Skip to content
DraconiticResearch
Search Sources API
197,693 studies31 sourcesUpdated 11 min ago
Peer-reviewedCC BY-NC 4.0BMJ Open

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

  • Annemarie Albert1
  • Frederike Vogel2
  • Linda Krause2
  • Louisa Blume3,4
  • Prasad Devarajan5
  • John Pickering6
  • Salvatore Di Somma7
  • Mina Hur8
  • Hanah Kim8
  • Chul Min Park9
  • Michael Haase10,11
  • Anja Haase-Fielitz12,13
19 more authors
  • Zoltan H. Endre14
  • Kent Doi15
  • Yohei Komaru15,16
  • Giovanni Introcaso17
  • Mercedes García Álvarez18
  • Suzana Bojic19
  • Abdushappar Gaipov20
  • Sebastian Lange3
  • Philipp Lauten21,22
  • Lisa C. Costello-Boerrigter21
  • Sabine Bleiziffer23
  • Miklos Lipcsey24
  • Gunnar Schley25
  • Philipp Stieger3
  • Jakub Udzik26
  • Tomasz Wróblewski26
  • Antonia Zapf2
  • Rüdiger C. Braun-Dullaeus3
  • Christian Albert1,3
26 affiliations
  1. 1Department of Nephrology, Central Clinic Bad Berka, Bad Berka, Germany
  2. 2Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  3. 3University Clinic for Cardiology and Angiology, Otto von Guericke University Magdeburg, Magdeburg, Germany
  4. 4Department of Neonatology, Charité University Medicine Berlin, Berlin, Germany
  5. 5University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA
  6. 6University of Otago Christchurch, Department of Medicine, Christchurch, New Zealand
  7. 7UNAM Sapientiam University La Sapienza and Great Health Science, Rome, Italy
  8. 8Department of Laboratory Medicine, Konkuk University, Gwangjin-gu, Seoul, Republic of Korea
  9. 9Dongnam Institute of Radiological & Medical Sciences, Konkuk University, Gwangjin-gu, Seoul, Republic of Korea
  10. 10Otto von Guericke University Magdeburg, Medical Faculty, Magdeburg, Germany
  11. 11Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
  12. 12Department of Cardiology, Immanuel Diakonie Bernau, Bernau, Germany
  13. 13Institute of Social Medicine and Health Systems Research, Otto von Guericke University Magdeburg, Magdeburg, Germany
  14. 14Department of Nephrology, Prince of Wales Hospital and Clinical School, University of New South Wales, Sydney, New South Wales, Australia
  15. 15Department of Emergency and Critical Care Medicine, The University of Tokyo, Bunkyo, Japan
  16. 16Division of Nephrology, Washington University in St. Louis, St. Louis, Missouri, USA
  17. 17Laboratorio Clinico, Centro Cardiologico Monzino IRCCS, Milano, Italy
  18. 18Department of Anesthesiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
  19. 19Department of Anaesthesiology, Resuscitation and Intensive Care, Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
  20. 20Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Astana, Kazakhstan
  21. 21Department of Cardiology and Intensive Care Medicine, Central Clinic Bad Berka, Bad Berka, Germany
  22. 22Philipps University of Marburg, Medical Faculty, Marburg, Germany
  23. 23Department of Cardiac Surgery, Central Clinic Bad Berka, Bad Berka, Germany
  24. 24Department of Surgical Sciences, Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
  25. 25Department of Nephrology and Hypertension, University Clinic Erlangen of Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
  26. 26Department of Cardiac Surgery, Pomeranian Medical University, Szczecin, Poland
Read full textDOICite

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.

Methods 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.

Exploratory 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.

Ethics 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.

PROSPERO registration number: CRD420261336943.

Related

  1. Development and Psychometric Assessment of a Measurement Instrument for Functioning and Function-Affecting Factors in Women With Breast Cancer: A Rasch Analysis Approach.
    Farkhondeh Jamshidihosseinabadi, Maryam Farzad, Enayatollah Bakhshi +7
    Journal of evaluation in clinical practicePeer-reviewedCC BYFull textOncologyEurope PMCPMC
  2. Individual patient disease activity expression profiles modify the relation between disease activity and structural damage progression in RA
    EULAR rheumatology openPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  3. Development and validation of a questionnaire to assess factors affecting the role effectiveness of intravenous therapy specialist nurses in Beijing, China.
    Shengxiao Nie, Hong Sun
    BMC nursingPeer-reviewedCC BY-NC-NDFull textGeneral medicineEurope PMCDOAJPMC
  4. Individual-level Structural Neuroimaging Biomarkers across the Psychosis Spectrum
    A. M. Rivas, E. Sari, C. Demirlek +15
    medRxivPreprintAll rights reservedFull textPsychiatry & mental healthmedRxiv
  5. Clinical Meaningfulness of Individual Items of the Brief Ataxia Rating Scale and the Scale for the Assessment and Rating of Ataxia
    D. Apaydin, J. D. Schmahmann
    medRxivPreprintAll rights reservedFull textNeurologymedRxiv

Cite

BibTeXRIS
BibTeX
@article{albert2026protocol,
  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}},
  author = {Annemarie Albert and Frederike Vogel and Linda Krause and Louisa Blume and Prasad Devarajan and John Pickering and Salvatore Di Somma and Mina Hur and Hanah Kim and Chul Min Park and Michael Haase and Anja Haase-Fielitz and Zoltan H. Endre and Kent Doi and Yohei Komaru and Giovanni Introcaso and Mercedes García Álvarez and Suzana Bojic and Abdushappar Gaipov and Sebastian Lange and Philipp Lauten and Lisa C. Costello-Boerrigter and Sabine Bleiziffer and Miklos Lipcsey and Gunnar Schley and Philipp Stieger and Jakub Udzik and Tomasz Wróblewski and Antonia Zapf and Rüdiger C. Braun-Dullaeus and Christian Albert},
  journal = {BMJ Open},
  year = {2026},
  month = oct,
  doi = {10.1136/bmjopen-2026-124451},
  url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-124451},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - 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
AU  - Annemarie Albert
AU  - Frederike Vogel
AU  - Linda Krause
AU  - Louisa Blume
AU  - Prasad Devarajan
AU  - John Pickering
AU  - Salvatore Di Somma
AU  - Mina Hur
AU  - Hanah Kim
AU  - Chul Min Park
AU  - Michael Haase
AU  - Anja Haase-Fielitz
AU  - Zoltan H. Endre
AU  - Kent Doi
AU  - Yohei Komaru
AU  - Giovanni Introcaso
AU  - Mercedes García Álvarez
AU  - Suzana Bojic
AU  - Abdushappar Gaipov
AU  - Sebastian Lange
AU  - Philipp Lauten
AU  - Lisa C. Costello-Boerrigter
AU  - Sabine Bleiziffer
AU  - Miklos Lipcsey
AU  - Gunnar Schley
AU  - Philipp Stieger
AU  - Jakub Udzik
AU  - Tomasz Wróblewski
AU  - Antonia Zapf
AU  - Rüdiger C. Braun-Dullaeus
AU  - Christian Albert
PY  - 2026
DA  - 2026/10/27
JO  - BMJ Open
DO  - 10.1136/bmjopen-2026-124451
UR  - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-124451
AB  - 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.  Methods 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.  Exploratory 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.  Ethics 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.  PROSPERO registration number: CRD420261336943.
SN  - 2044-6055
SN  - 2044-6055
ER  -