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Shereen Abdelghaffar,1 Hassan Shora,2 Sahar Abdelatty,3 Fatma Elmougy,3 Reham El Sayed,3 Heba Abdelrahman,3 Hend Soliman,1 HebatAllah Algebaly,1 Sakinatalfouad Ahmed,1 Peter Alfy,1 Yasmine Elshiwy3 1Department of Pediatrics, Cairo University, Cairo, Egypt; 2Department of Molecular Biology/Biochemistry, Port Said University, Port Said, Egypt; 3Department of Clinical and Chemical Pathology, Cairo University, Cairo, EgyptCorrespondence: Shereen AbdelghaffarDepartment of Pediatrics, Faculty of Medicine, Cairo University, Cairo, EgyptTel +201005859252Fax +201272202209Email kshereen@kasralainy.edu.egPurpose: Currently available markers for early detection of diabetic nephropathy (DN), the leading cause of end stage renal disease, have some limitations. There is insufficient evidence from previous studies about the role of several circulating microRNAs (miRNAs) in the early development of DN. This study aimed to describe the expression of miRNA-377, miRNA-93, miRNA-25, miRNA-216a, and miRNA-21 in a sample of type 1 diabetic children and adolescents to explore their association with DN and some indices of kidney injury.Patients and Methods: Seventy type 1 diabetic patients, with 5 years’ duration of diabetes or more, were recruited from Children’s Hospital, Faculty of Medicine, Cairo University. Quantitative real-time reverse-transcription PCR (qRT-PCR) was used to measure the expression of the above mentioned miRNAs in serum and to assess its association with DN, and the studied risk factors.Results: There was a significantly higher percentage of up-regulation of miRNA-377 and miRNA-93 (P=0.03, 0.02, respectively) in addition to significant down-regulation of miRNA-25 (P=0.01) in patients with DN than in patients without DN. In patients with DN, expression of miR-216a was significantly negatively correlated with creatinine (r=− 0.4, P=0.04) and positively correlated with eGFR using creatinine (r=0.5, P=0.03). In the same group, expression of miR-21 was positively correlated with urinary cystatin C (r=0.6, P=0.01) and was negatively correlated with e-GFR using cystatin c (r=− 0.6, P=0.01). miRNA-93 was associated with increased risk (odds ratio=15, 95% CI=12.03– 24.63, P=0.01), while miRNA-25 was associated with decreased risk for albuminuria (odds ratio=0.15, 95% CI=0.08– 0.55, P=0.03).Conclusion: miRNA-377, miRNA-93, miRNA-216a, and miRNA-21 may be implicated in the pathogenesis of DN, while miRNA-25 may have a reno-protective role. More studies are needed to document the value of these miRNAs as diagnostic biomarkers as well as therapeutic targets in DN.Keywords: microRNAs, type 1 diabetes, diabetic nephropathy, albuminuria, children