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.