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

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Summary

Introduction

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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