Uremic toxins levels are associated with miR-223 in chronic kidney disease-associated anemia

Chronic kidney disease (CKD) poses a significant threat, with increased rates of cardiovascular and all-cause mortality. Anemia, common in CKD, is associated with accumulation of uremic toxins in the bloodstream. We previously demonstrated that the uremic toxin indoxyl sulfate (IS) impacts the regulation of erythropoiesis in cellular and preclinical CKD models. Here, the role of non-coding RNAs in this toxic effect was evaluated. The effect of IS on microRNA expression was measured in human erythropoietic cell line UT7/EPO, using nanostring. We found a significant increase of miR-223 in cells treated with IS. This finding was further validated in human primary CD34⁺ cells, a more physiological model for human erythropoiesis. Finally, serum levels of miR-223 correlated with representative uremic toxins, including IS, in patients with various stages of CKD, and also with endothelial dysfunction markers, indicating a link with vascular damage. These correlations varied according to erythropoietin treatment and dialysis. These findings suggest that miR-223 may play a role in the development of anemia in CKD. Further investigation into the involvement of miR-223 in erythropoiesis is needed for a better understanding of the mechanisms underlying anemia in CKD and the potential role of uremic toxins. Ultimately, this may open up new therapeutic possibilities for the management of anemia in CKD.