The Role of MicroRNA Regulation on Clinical Outcomes in Kidney Disease

MicroRNAs (miRs), small noncoding RNAs that regulate gene expression post-transcriptionally, have been shown to vary in their expression throughout CKD stages, dialysis modality, alterations in left ventricular hypertrophy, vascular tone, and inflammation. In addition, fluctuations in miR expression have been reported with various hemodialysis regimens, although whether these alterations contribute mechanistically to the observed clinical effects remains unresolved. The relative stability of miRs in biologic fluids offers an opportunity for the identification of biomarkers for disease monitoring and assessing for therapeutic intervention. We will review the current understanding of miR regulation within the context of dialysis, to better define the molecular impact of conventional and intensive hemodialysis and guide the development of targeted strategies to mitigate CKD-related complications.