Introduction: Acute kidney injury following cardiac surgery is a dreaded complication contributing to early mortality. Diagnosing AKI using serum creatinine usually results in a delay. To combat this, certain kidney damage specific biomarkers were investigated to identify if they can serve as early predictors of cardiac surgery-associated AKI (CSA-AKI). This study systematically reviews three such biomarkers; NGAL, tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein-7 (IGFBP7) to identify if they can serve as early predictors of CSA-AKI.

Methods: Systematic search was carried out on literature reporting the diagnostic ability of the three biomarkers from databases in accordance with PRISMA guidelines.

Results: We found 43 articles reporting urinary-NGAL levels (n = 34 in adults, n = 9 in children) and 10 studies reporting TIMP-2 and IGFBP7 levels among adults. Interestingly, NGAL showed high diagnostic value in predicting AKI in children (seven among nine studies with AUROC > 0.8). The cell cycle arrest biomarkers, namely TIMP-2 and IGFBP7, showed high diagnostic value in predicting AKI in adults (five among ten studies with AUROC > 0.8).

Conclusion: In predicting CSA-AKI; the diagnostic value of NGAL is high in the paediatric population while the diagnostic value of TIMP-2 and IGFBP7 is high in adults.

简介：心脏手术后的急性肾损伤是一种可怕的并发症，可导致早期死亡。使用血清肌酐诊断AKI通常会导致延迟。为了解决这个问题，研究了某些特定于肾脏损伤的生物标记物，以确定它们是否可以作为与心脏手术相关的AKI（CSA-AKI）的早期预测指标。这项研究系统地回顾了三个这样的生物标记。NGAL，基质金属蛋白酶2（TIMP-2）和胰岛素样生长因子结合蛋白7（IGFBP7）的组织抑制剂，以鉴定它们是否可以作为CSA-AKI的早期预测指标。

方法：根据PRISMA指南，从数据库中对报告这三种生物标志物诊断能力的文献进行系统搜索。

结果：我们发现43篇报道尿NGAL水平的文章（成人n  =  34 ，儿童n  =  9）和10篇报告成人中TIMP-2和IGFBP7水平的研究。有趣的是，NGAL在预测儿童AKI方面显示出较高的诊断价值（在AUROC  >  0.8的9项研究中有7项）。细胞周期阻滞生物标记物TIMP-2和IGFBP7在预测成人AKI中显示出较高的诊断价值（十项研究中AUROC  >  0.8的五项）。

结论：在预测CSA-AKI中；NGAL在儿科人群中的诊断价值较高，而TIMP-2和IGFBP7在成人中的诊断价值较高。