Association Between Low Serum microRNA-26a Levels and Major Adverse Cardiovascular or Cerebrovascular Events in Patients Undergoing Hemodialysis.

OBJECTIVES

Patients with end-stage kidney disease face an extremely high risk of major adverse cardiovascular and cerebrovascular events. This study investigated the role of microRNA-26a in patients with end-stage kidney disease who have been receiving long-term hemodialysis.

METHODS

Blood samples were collected from patients with chronic kidney disease stages I-III and from those with end-stage kidney disease. Basic clinical information was recorded for all participants. Serum expression of microRNA-26a was measured using real-time quantitative polymerase chain reaction. Pearson correlation analysis was used to examine the relationships between microRNA-26a levels and clinical indicators, including serum albumin, estimated glomerular filtration rate, high-sensitivity C-reactive protein, serum creatinine, and blood urea nitrogen. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the association of microRNA-26a with disease progression and the occurrence of major adverse cardiovascular and cerebrovascular events.

RESULTS

Serum microRNA-26a levels were significantly lower in patients with end-stage kidney disease compared with those with earlier-stage chronic kidney disease. MicroRNA-26a expression showed a positive correlation with serum albumin and estimated glomerular filtration rate, and negative correlations with high-sensitivity C-reactive protein, serum creatinine, and blood urea nitrogen. ROC curve analysis demonstrated that serum microRNA-26a levels had good diagnostic value for identifying end-stage kidney disease (area under the curve = 0.842). During follow-up, the cumulative incidence of major adverse cardiovascular and cerebrovascular events was 14% at 12 months, 22% at 24 months, and 34% at 36 months. MicroRNA-26a expression was significantly lower in patients who experienced these events. Both univariate and multivariate logistic regression analyses identified higher serum microRNA-26a levels as an independent protective factor against major adverse cardiovascular and cerebrovascular events in patients with end-stage kidney disease.

CONCLUSION

In patients with end-stage kidney disease receiving long-term hemodialysis, microRNA-26a levels are associated with disease severity and the risk of major adverse cardiovascular and cerebrovascular events. Lower miR-26a expression may serve as a potential biomarker for disease monitoring and risk stratification.