(Open access funding provided by Semmelweis University)
Stipendium Hungaricum Scholarship(Stipendium) Támogató: Tempus
(SE250+ Excellence Scholarship for PhD Students)
(BO/00304/20/5)
Background: Accurate detection of kidney damage is key to preventing renal failure,
and identifying biomarkers is essential for this purpose. We aimed to assess the accuracy
of miRNAs as diagnostic tools for chronic kidney disease (CKD). Methods: We thoroughly
searched five databases (MEDLINE, Web of Science, Embase, Scopus, and CENTRAL) and
performed a meta-analysis using R software. We assessed the overall diagnostic potential
using the pooled area under the curve (pAUC), sensitivity (SEN), and specificity (SPE)
values and the risk of bias by using the QUADAS-2 tool. The study protocol was registered
on PROSPERO (CRD42021282785). Results: We analyzed data from 8351 CKD patients, 2989
healthy individuals, and 4331 people with chronic diseases. Among the single miRNAs,
the pooled SEN was 0.82, and the SPE was 0.81 for diabetic nephropathy (DN) vs. diabetes
mellitus (DM). The SEN and SPE were 0.91 and 0.89 for DN and healthy controls, respectively.
miR-192 was the most frequently reported miRNA in DN patients, with a pAUC of 0.91
and SEN and SPE of 0.89 and 0.89, respectively, compared to those in healthy controls.
The panel of miRNAs outperformed the single miRNAs (pAUC of 0.86 vs. 0.79, p < 0.05).
The SEN and SPE of the panel miRNAs were 0.89 and 0.73, respectively, for DN vs. DM.
In the lupus nephritis (LN) vs. systemic lupus erythematosus (SLE) cohorts, the SEN
and SPE were 0.84 and 0.81, respectively. Urinary miRNAs tended to be more effective
than blood miRNAs (p = 0.06). Conclusion: MiRNAs show promise as effective diagnostic
markers for CKD. The detection of miRNAs in urine and the use of a panel of miRNAs
allows more accurate diagnosis.
