Metabolomics biomarkers and related pathways in acute renal injury: a bibliometric investigation, meta-analysis, and systematic review.

Objective: Early diagnosis of Acute Kidney Injury (AKI) is critical for improving patient outcomes. This study aims to provide a comprehensive overview of the research landscape and to identify key metabolic biomarkers and pathways associated with AKI through bibliometric analysis and meta-analysis. Methods: We conducted a bibliometric analysis of scientific articles on metabolomics in AKI published between 2005 and 2025. Building on this bibliometric foundation, we performed a systematic review and meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to delve deeper into the synthesis of findings on diagnostic metabolites. Results: (1) Bibliometric analysis shows rapid growth and international collaboration in AKI metabolomics research. Studies focused on risk factors, management, and underlying mechanisms. (2) Meta-analysis reveals that decreased glycine, lysine, and cystine, along with increased tryptophan, distinguish AKI patients from healthy controls. These metabolites are sensitive diagnostic biomarkers. (3) Enriched pathways identified by Human Metabolome Database (HMDB) and Kyoto Encyclopedia of Genes and Genomes (KEGG) suggest that amino acid metabolism are key contributors to AKI pathogenesis. Discussion: This systematic review highlights the significant diagnostic and mechanistic value of metabolomics in AKI. The identified metabolite panel and associated pathways offer promising targets for early diagnosis and elucidate critical aspects of the disease's underlying biology.