Evidence map›Paper›PMID 40440346›Full record

SynthesisPloS one2025

Saliva urea nitrogen for detection of kidney disease in adults: A meta-analysis of diagnostic test accuracy.

Reyna Kumaran, Mona Mohamed Ibrahim Abdalla, Brinnell Annette Caszo, Sushela Devi Somanath

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Reyna KumaranHuman Biology Department, School of Medicine, IMU University (Formerly known as International Medical University), Kuala Lumpur, Malaysia.ORCID https://orcid.org/0009-0009-5728-3033
Mona Mohamed Ibrahim AbdallaHuman Biology Department, School of Medicine, IMU University (Formerly known as International Medical University), Kuala Lumpur, Malaysia.ORCID https://orcid.org/0000-0002-4987-9517
Brinnell Annette CaszoHuman Biology Department, School of Medicine, IMU University (Formerly known as International Medical University), Kuala Lumpur, Malaysia.
Sushela Devi SomanathPathology Department, School of Medicine, IMU University (Formerly known as International Medical University), Kuala Lumpur, Malaysia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKidney disease affects millions globally, especially in low and middle-income countries where access to diagnostic testing is limited. Saliva urea nitrogen (SUN) has been proposed as a simple, non-invasive alternative to traditional serum-based diagnostics.

objectiveThis study aimed to evaluate the diagnostic accuracy of SUN for detecting kidney disease in adults through a systematic review and meta-analysis.

methodsThis review adhered to the PRISMA-DTA guidelines. A comprehensive search of five databases was conducted without language or date restrictions. Study quality was assessed using the QUADAS-2 tool. STATA version 17 was used for analysis. A random-effects model was used to estimate pooled sensitivity, specificity, and diagnostic odds ratios (DOR). Subgroup analysis was conducted based on the reference test used (serum creatinine or blood urea nitrogen). Heterogeneity was assessed using the I² statistic, and meta-regression explored sources of heterogeneity.

resultsSeven studies (n = 1,933) met the inclusion criteria. In the serum creatinine (sCr) subgroup (2 studies), SUN showed pooled sensitivity of 0.44 (95% CI: 0.38-0.49), specificity 0.96 (95% CI: 0.95-0.98), DOR 18.89 (95% CI: 15.19-23.57), and AUC ~ 0.90. In the blood urea nitrogen (BUN) subgroup (5 studies), sensitivity was 0.83 (95% CI: 0.69-0.91), specificity 0.88 (95% CI: 0.78-0.94), DOR 37 (95% CI: 15-91), and AUC 0.93. Heterogeneity was moderate in the BUN subgroup (bivariate I² = 51%), with 42% of variability attributed to threshold effects. Meta-regression identified study country (p = 0.01), and reference test used (p = 0.02) as contributors to heterogeneity in sensitivity, while comorbidity (p = 0.001) significantly affected specificity.

conclusionSUN shows high diagnostic specificity and a good overall accuracy, particularly when compared to BUN, and may serve as a practical non-invasive screening tool in low- resource settings. While heterogeneity was present, SUN remains a promising diagnostic alternative and warrants further validation in diverse clinical populations.

Indexed as

Diagnostic Tests, RoutineKidney DiseasesSalivaUreaAdultBlood Urea NitrogenCreatinineHumansSensitivity and SpecificityCreatinineUrea

Identifiers

PMID40440346
PMCPMC12121763

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.