Panel miRNAs are potential diagnostic markers for chronic kidney diseases: a systematic review and meta-analysis.

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. Key Learning Points: 1. The diagnostic performance of miRNAs in chronic kidney diseases needs to be investigated, as previous systematic reviews and meta-analyses are scarce, and individual cohort studies have confirmed their importance in kidney pathophysiology. 2. Using multiple miRNAs as biomarkers can lead to more precise CKD diagnosis, as they outperform single miRNAs compared to healthy and people with chronic disease groups. The overall diagnostic accuracy of urinary miRNAs tended to be greater than that of blood samples, suggesting that they are noninvasive and readily available diagnostic markers in CKD patients. 3. Incorporating miRNAs as diagnostic markers for CKD in combination with traditional markers might improve the accuracy and efficiency of diagnosis. To optimize miRNA diagnostic performance, it is essential to consider the various biological sample types, comparison groups (control), and different kidney diseases. [ABSTRACT FROM AUTHOR]