Urinary sediment microRNAs can be used as potential noninvasive biomarkers for diagnosis, reflecting the severity and prognosis of diabetic nephropathy

Abstract

Background Patients with both diabetes mellitus (DM) and kidney disease could have diabetic nephropathy (DN) or non-diabetic renal disease (NDRD). IgA nephropathy (IgAN) and membranous nephropathy (MN) are the major types of NDRD. No ideal noninvasive diagnostic model exists for differentiating them. Our study sought to construct diagnostic models for these diseases and to identify noninvasive biomarkers that can reflect the severity and prognosis of DN. Methods The diagnostic models were constructed using logistic regression analysis and were validated in an external cohort by receiver operating characteristic curve analysis method. The associations between these microRNAs and disease severity and prognosis were explored using Pearson correlation analysis, Cox regression, Kaplan–Meier survival curves, and log-rank tests. Results Our diagnostic models showed that miR-95-3p, miR-185-5p, miR-1246, and miR-631 could serve as simple and noninvasive tools to distinguish patients with DM, DN, DM with IgAN, and DM with MN. The areas under the curve of the diagnostic models for the four diseases were 0.995, 0.863, 0.859, and 0.792, respectively. The miR-95-3p level was positively correlated with the estimated glomerular filtration rate (p < 0.001) but was negatively correlated with serum creatinine (p < 0.01), classes of glomerular lesions (p < 0.05), and scores of interstitial and vascular lesions (p < 0.05). However, the miR-631 level was positively correlated with proteinuria (p < 0.001). A low miR-95-3p level and a high miR-631 level increased the risk of progression to end-stage renal disease (p = 0.002, p = 0.011). Conclusions These four microRNAs could be noninvasive tools for distinguishing patients with DN and NDRD. The levels of miR-95-3p and miR-631 could reflect the severity and prognosis of DN.

Predictive significance of joint plasma fibrinogen and urinary alpha-1 microglobulin-creatinine ratio in patients with diabetic kidney disease

“…In development and progression of T2D and DKD, some basic biomarkers in blood and urine may directly demonstrate the status of disease, and are sure to be good predictors [27][28][29][30]. In this study, when using plasma FIB and urinary α1-MG/CR as well as their combination as predictive factors, their optimal cut-off points would be needed to categorize patients with and without the risk.…”

MicroRNAs Associated with Chronic Kidney Disease in the General Population and High-Risk Subgroups—A Systematic Review

“…Moreover, lower levels of this miRNA were associated with lower levels of eGFR [ 32 ], and prevalent CKD [ 21 ]. Although commonly considered to be involved in inflammatory pathways, evidence also suggests a protective role of miR-223 in VSMCs, through the inhibition of calcification by the regulation of interleukin-6 (IL-6)/signal transducer and activator of transcription 3 (STAT3) [ 63 ]. These findings imply that increased levels of miR-223 may improve kidney function, and thus may serve as a therapeutic strategy to improve CKD outcomes in the general population.…”

Diabetes mellitus with a duration of 26 years combined with IgA nephropathy: A case report and literature review

“…The results of the present study suggest that clinicians should be open-minded and carefully identify patients with long DM duration combined with kidney disease in order to reduce misdiagnosis and missed diagnoses. In the future, several biomarkers, including miR-95-3p, miR-185-5p, miR-1246, and miR-631, are expected to serve as simple and non-invasive tools for use in differentiating DM, DKD, DM combined with IgAN, and DM combined with MN (15).…”