• Paweena Susantitaphong, Monchai Siribamrungwong, Kent Doi, Eisei Noiri, Norma Terrin, and Bertrand L Jaber.
• Department of Medicine, Division of Nephrology, Kidney and Dialysis Research Laboratory, St. Elizabeth's Medical Center, Boston, MA 02135, USA.
• Am. J. Kidney Dis. 2013 Mar 1;61(3):430-9.

BackgroundUrinary liver-type fatty acid-binding protein (L-FABP) is a proximal tubular injury candidate biomarker for early detection of acute kidney injury (AKI), with variable performance characteristics depending on clinical settings.Study DesignMeta-analysis of diagnostic test studies assessing the performance of urinary L-FABP in AKI.Setting & PopulationLiterature search in MEDLINE, EMBASE, Scopus, Google Scholar, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov using search terms "liver-type fatty acid-binding protein" and "L-FABP."Selection Criteria For StudiesStudies of humans investigating the performance characteristics of urinary L-FABP for the early diagnosis of AKI and AKI-related outcomes, including dialysis requirement and mortality.PredictorUrinary L-FABP.OutcomesDiagnosis of AKI, dialysis requirement, and in-hospital death.Results15 prospective cohort and 2 case-control studies were identified. Only 7 cohort studies could be meta-analyzed. The estimated sensitivity of urinary L-FABP level for the diagnosis of AKI was 74.5% (95% CI, 60.4%-84.8%), and specificity was 77.6% (95% CI, 61.5%-88.2%). The estimated sensitivity of urinary L-FABP level for predicting dialysis requirement was 69.1% (95% CI, 34.6%-90.5%), and specificity was 42.7% (95% CI, 3.1%-94.5%); for in-hospital mortality, sensitivity and specificity were 93.2% (95% CI, 66.2%-99.0%) and 78.8% (95% CI, 27.0%-97.4%), respectively.LimitationsPaucity and low quality of studies, different clinical settings, and variable definitions of AKI.ConclusionsAlthough urinary L-FABP may be a promising biomarker for early detection of AKI and prediction of dialysis requirement and in-hospital mortality, its potential value needs to be validated in large studies and across a broader spectrum of clinical settings.Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

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