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

作者：Ruilian You, Hua Zheng, Lubin Xu, Tiantian Ma, Gang Chen, Peng Xia, Xiaohong Fan, Peili Ji, Li Wang, Limeng Chen · 发表于：Journal of Intensive Care · 年份：2021 · DOI：10.1186/s40560-021-00584-2 · 被引用次数：17 · 研究领域：Acute Kidney Injury Research、Kidney Stones and Urolithiasis Treatments、Pediatric Urology and Nephrology Studies

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, I 2 = 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, I 2 = 89%). Meta-reggression found that age was associated with the SMD of uUMOD. The study outcome was reliably co...