Diagnostic value of urinary protein to creatinine (UPC) ratio in dogs with chronic kidney disease (CKD): a systematic meta-analysis.

The objective of the present meta-analysis was to get a conclusion about the diagnostic value of urine protein to creatinine (UPC) ratio in dogs with chronic kidney disease (CKD). According to the guidelines of the PRISMA statement, Web of Science, Scopus, PubMed, Sage and google scholar were searched. Standardized mean difference (SMD), odds ratio (OR), and confidence interval (CI at 95%) were calculated. Heterogenicity and publication bias were evaluated in this study at random effect model. Nine studies, with a total of 891 dogs were included in the meta-analysis after duplicates and irrelevant records were eliminated. Of all, 543 dogs had CKD and 348 were healthy control. The SMD showed that the pooled effect size at random effect was 0.85; variance was 0.027; and CI at 95% was 0.53–1.17. Hedges’g and CI at 95% revealed that there was a large size effect (OR:0.83; CI 95%: 0.52–1.15; p < 0.001). The odds ratio (OR) and confidence interval for the variation of UPC ratio in control dogs and in dogs with CKD were (OR: 2.93; CI: 2.26–3.82; p < 0.001). The variables of heterogenicity revealed publication bias and showed a Q value of 30.53 (p < 0.001) and I2 of 73.79. The results of publication bias revealed that the Egger’s regression intercept was 3.87 (p < 0.001); the Begg and Mazumdar rank correlation was moderate correlation (0.63, p < 0.05) and the funnel plot is asymmetric. Moreover, the Fail-safe N test revealed that high number of missing studies are required (198.000), indicating a publication bias. In conclusion, the results of this meta-analysis on the UPC ratio in dogs with chronic kidney disease its potential diagnostic biomarkers. However, these conclusions should be interpreted with caution due to the various factors that affect UPC ratio.