Abstract
End-stage renal disease (ESRD) is a rapidly increasing global health and healthcare challenge. MicroRNAs (miRNAs) have been implicated in kidney disease due to their role in apoptosis, cell proliferation, differentiation, and development. The aim of this study was to determine the role of miRNA-21-5p, miRNA-126-3p, and miRNA-192-5p in the prognosis of ESRD. In addition, we aimed to evaluate the discriminatory ability of these miRNAs as biomarkers for ESRD in relation to the comorbidities of hypertension (HTN) and diabetes mellitus (DM). One hundred and ten individuals were recruited for our study and divided into three groups: group 1 included 40 ESRD patients with hypertension, group 2 included 40 ESRD patients with diabetes, and group 3 (n = 30) served as healthy controls. Real-time polymerase chain reaction (RT-PCR) was used to quantify the above miRNAs. Patients with ESRD were found to have lower levels of miRNA-126-3p and higher levels of miRNAs-21-5p and - 192-5p. Furthermore, the accuracies of ROC analyses for miR-21-5p, miR-126-3p, and miR-192-5p were 96.65%, 99.5%, and 93.35% in ESRD with HTN and 95%, 71.5%, and 93% in ESRD with DM. Dysregulation of these miRNAs is associated with the development of ESRD and could be used as biomarkers for ESRD. This study briefly outlines the challenges associated with miRNA research and the potential use of miRNA molecules in the management of ESRD, proposing a research approach emphasizing the development of standardized and reliable biomarkers for therapeutic use. Despite the promising diagnostic utility demonstrated, the lack of cross-validation and external validation remains an important limitation. Future large-scale, independent studies are essential to confirm these findings and ensure broader applicability.