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Curr Opin Nephrol Hypertens
2019[Sep]; 28
(5
): 481-489
PMID31205055
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PURPOSE OF REVIEW: Uromodulin (UMOD), also known as Tamm-Horsfall protein, is the
most abundant protein in human urine. UMOD has multiple functions such as
protection against urinary tract infections and nephrolithiasis. This review
outlines recent progress made in UMOD's role in renal physiology, tubular
transport, and mineral metabolism. RECENT FINDINGS: UMOD is mostly secreted in
the thick ascending limb (TAL) and to a lesser degree in the distal convoluted
tubule (DCT). UMOD secretion is regulated by the calcium-sensing receptor. UMOD
upregulates ion channels [e.g., renal outer medullary potassium channel,
transient receptor potential cation channel subfamily V member 5, and transient
receptor potential melastatin 6 (TRPM6)] and cotransporters [e.g., Na,K,2Cl
cotransporter (NKCC2) and sodium-chloride cotransporter (NCC)] in the TAL and
DCT. Higher serum UMOD concentrations have been associated with higher renal
function and preserved renal reserve. Higher serum UMOD has also been linked to a
lower risk of cardiovascular disease and diabetes mellitus. SUMMARY: With better
serum UMOD detection assays the extent of different functions for UMOD is still
expanding. Urinary UMOD regulates different tubular ion channels and
cotransporters. Variations of urinary UMOD secretion can so contribute to common
disorders such as hypertension or nephrolithiasis.
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