The pooled analysis demonstrated significant diagnostic utility of urinary TIMP-2/IGFBP7 (combined or individual) for pediatric AKI: Sensitivity: 0.84 (95% CI: 0.71–0.91), Specificity: 0.85 (95% CI: 0.76–0.91), AUROC): 0.91 (95% CI: 0.88–0.93), Positive Likelihood Ratio (PLR): 5.6, Negative Likelihood Ratio (NLR): 0.19, Diagnostic Odds Ratio (DOR): 29, Substantial heterogeneity was observed: Sensitivity: I2 = 80.35%, Cochran's Q = 71.25 (P < 0.001), Specificity: I2 = 93.73%, Cochran's Q = 223.27 (P < 0.001), A random-effects model was therefore applied. The gene discussed is IGFBP7; the disease is acute kidney injury.