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Abstract
BackgroundUrinary 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.MethodsWe 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.ResultsThe 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.ConclusionThe present study suggested a negative association between uUMOD and AKI especially in children and surgical patients.
Highlights
Acute kidney injury (AKI) is a collection of syndromes characterized by a sudden decrease in glomerular filtration rate, induced by various causes, like dehydration, sepsis, glomerulonephritis, and acute intoxication
Three studies investigated the relationship between Urinary uromodulin (uUMOD) and surgery-associated AKI, while two studies recruited participants undergoing renal transplant surgery
The patients in five studies are below 18 years old, with infants and newborns in three studies
Summary
Acute kidney injury (AKI) is a collection of syndromes characterized by a sudden decrease in glomerular filtration rate, induced by various causes, like dehydration, sepsis, glomerulonephritis, and acute intoxication. × insulin-like growth factor-binding protein 7 (IGFBP7), and C–C Motif Chemokine Ligand 14 (CCL14) have been studied for diagnostic value in early AKI detection [4]. These biomarkers reflect the cell injury in the setting of AKI, other than the cell function, which can identify a patient’s predisposition and risk of developing AKI. The results among these studies are inconsistent due to their limited sample size We conducted this meta-analysis to evaluate the difference of uromodulin between AKI and non-AKI. We designed this meta-analysis to evaluate the potential association between uUMOD and AKI
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