Prognostic nutritional index as a predictive marker for acute kidney injury in adult critical illness population: a systematic review and diagnostic test accuracy meta-analysis
Authors' conclusion
Our study demonstrated that PNI has practical accuracy for predicting the development of AKI in critically ill populations, with superior diagnostic performance observed in medical and non-CKD populations.
Study context
- Population
- Critically ill adults
- Participants
- 21,239 adults · 16 studies · 17 cohorts
- Outcome
- Predictive accuracy of PNI for acute kidney injury (AKI)
Methodological detailssubgroup analyses, meta-regression, GRADE
- Subgroup analyses
- Meta-regression
- GRADE
Pooled result
As reported in the abstract
AKI prediction
| Group | Pooled sensitivity | Pooled specificity | Positive likelihood ratio | Negative likelihood ratio | Diagnostic OR | Summary ROC AUC |
|---|---|---|---|---|---|---|
| Prognostic nutritional index (PNI) | 0.67 (95% CI 0.58-0.74) | 0.74 (95% CI 0.67-0.80) | 2.49 (95% CI 1.99-3.11; low certainty) | 0.46 (95% CI 0.37-0.56; low certainty) | 5.54 (95% CI 3.80-8.07) | 0.76 |
Prognostic nutritional index (PNI)
Pooled sensitivity0.67 (95% CI 0.58-0.74)
Pooled specificity0.74 (95% CI 0.67-0.80)
Positive likelihood ratio2.49 (95% CI 1.99-3.11; low certainty)
Negative likelihood ratio0.46 (95% CI 0.37-0.56; low certainty)
Diagnostic OR5.54 (95% CI 3.80-8.07)
Summary ROC AUC0.76
Further pooled results
| Outcome | Sensitivity | P value |
|---|---|---|
| Sensitivity, medical vs surgical populations (subgroup) | 0.72 vs. 0.55 | P < 0.05 |
| Sensitivity, studies excluding vs including CKD (subgroup) | 0.75 vs. 0.56 | P < 0.01 |
Sensitivity, studies excluding vs including chronic kidney disease (CKD) (subgroup)
- Overall diagnostic performance superior in the non-CKD group
Original publication
Prognostic nutritional index as a predictive marker for acute kidney injury in adult critical illness population: a systematic review and diagnostic test accuracy meta-analysis. J Intensive Care. Published 26 April 2024. doi:10.
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