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. 2021 Nov 15;9(1):70.
doi: 10.1186/s40560-021-00584-2.

Decreased urinary uromodulin is potentially associated with acute kidney injury: a systematic review and meta-analysis

Ruilian You #  1 , Hua Zheng #  1 , Lubin Xu  1 , Tiantian Ma  1 , Gang Chen  1 , Peng Xia  1 , Xiaohong Fan  1 , Peili Ji  1 , Li Wang  2 , Limeng Chen  3
Affiliations

Decreased urinary uromodulin is potentially associated with acute kidney injury: a systematic review and meta-analysis

Ruilian You et al. J Intensive Care. .

Abstract

Background: Urinary uromodulin (uUMOD) is one of the novel biomarkers for predicting AKI. However, currently available publications showed inconsistent results. We designed this meta-analysis to evaluate the potential association between uUMOD and AKI.

Methods: We searched research articles with no language restriction in Medline, Web of Science, Cochrane Library, Embase, and 3 Chinese datasets from inception to February 2021. We used random-effects models to estimate the standardized mean difference (SMD) between patients with AKI or not, while the leave-one-out method and random-effects meta-regression to evaluate the sensitivity and the impact of potential confounders such as age and surgery.

Results: The meta-analysis comprising 3148 subjects from 11 studies showed that the uUMOD of the AKI group is significantly lower than the non-AKI group (SMD: - 0.71; 95% confidence interval (CI), - 1.00, - 0.42, P < 0. 001, I2 = 78.8%). Subgroup analysis revealed the difference is also significant in a different age, surgery condition, and assay time but not acute rejection (AR) group, especially in children (SMD: - 1.21, 95% CI: - 1.80, - 0.61; P < 0.001) and patients undergoing surgery (SMD: - 1.03, 95% CI: - 1.75, - 0.30; P < 0.001). Lower uromodulin is associated with higher odds for AKI incidence (odds ratio = 2.47, 95% CI: 1.12, 5.47; P < 0.001, I2 = 89%). Meta-reggression found that age was associated with the SMD of uUMOD. The study outcome was reliably confirmed by the sensitivity analysis.

Conclusion: The present study suggested a negative association between uUMOD and AKI especially in children and surgical patients.

Keywords: Acute kidney injury; Biomarkers; Uromodulin.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Search plot diagram. Additional records include articles searching from the Chinese language database. sUMOD serum uromodulin
Fig. 2
Fig. 2
Risk of bias for included studies
Fig. 3
Fig. 3
Subgroup analysis of the difference between urinary uromodulin in the patients of AKI and non-AKI according to age (A), surgery condition (B) and assay time (C). AKI acute kidney injury, AR acute rejection, CI confident interval, SMD standardized mean difference
Fig. 4
Fig. 4
A forest plot of incidence of acute kidney injury. CI confident interval, OR odds ratio
See this image and copyright information in PMC

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