Prognostic significance of uromodulin in contrast-induced nephropathy: a systematic review

Contrast-induced nephropathy (CIN) remains a leading cause of hospital-acquired acute kidney injury (AKI) despite progress in diagnosis and treatment. Objective. To perform an analysis of the prognostic significance of uromodulin as a biomarker for the risk of contrast-induced nephropathy development, determine its association with clinical outcomes and its role in stratifying patient groups before contrast-enhanced studies. Materials and methods. Current data on the significance of uromodulin as a predictor of the development of CIN were analyzed. Literature search was carried out in eLibrary, PubMed, Google Scholar and Scopus databases (2008—2025). Results. CIN diagnosis is a diagnosis of exclusion that is established based on the differential diagnosis of AKI of another etiology. In clinical practice, the traditional markers of AKI (serum creatinine level, diuresis) reflect its development in a delayed period of time after tubular apparatus damage. Uromodulin is the most accurate biomarker of renal tubular epithelial injury. Its level in urine decreases in the initial damage with radiopaque agents. As opposed to traditional AKI markers, the level of which increase after injury (e.g., NGAL, KIM-1), serum and urine uromodulin reflects the basic renal functional capacity. Determination of uromodulin level before performing contrast-enhanced studies may be an important element in the stratification of CIN risk, especially in patients with predisposition factors — old age, renal diseases, diabetes, heart failure. Conclusion. Uromodulin is a promising marker of tubule condition and risk stratification for contrast-induced nephropathy development. Its determination before contrast-enhanced procedures, especially in combination with other biomarkers, will increase prediction accuracy, optimize prevention and improve outcomes in high-risk patients.