Uromodulin as a protein and genetic biomarker for hypertension: A detailed systematic review and meta-analysis.

BACKGROUND

Hypertension is a major global cause of cardiovascular morbidity and mortality, and improved biomarkers are needed to assess risk, disease progression, and treatment response. Uromodulin reflects tubular health and renal sodium handling and has been linked to hypertension. We performed a systematic review and meta-analysis to evaluate uromodulin as a biomarker for hypertension.

METHODS

We included human studies evaluating uromodulin protein levels or uromodulin-related genome-wide association study outcomes in relation to hypertension. Continuous outcomes were analyzed using inverse variance weighted random effects models, and publication bias was assessed with Begg's test, Egger's test, and funnel plots.

RESULTS

Thirty-five studies met the inclusion criteria. Across diagnostic, prognostic, and predictive biomarker studies, ∼10,726 individuals with hypertension (3,461 females) and ∼8,762 (3,605 females) normotensives were included. Genome-wide association studies included > 450,000 hypertension and > 150,000 normotensives. Across all analyses, uromodulin did not demonstrate clinically meaningful utility as a biomarker for hypertension or hypertension-related outcomes.

CONCLUSION

Our meta-analysis shows that uromodulin is not a clinically useful protein or genetic biomarker for hypertension or hypertension-related outcomes. However, it may still have potential utility in predicting other cardiovascular outcomes.