miRNA-210 expression is associated with iron deficiency and biochemical parameters in hemodialysis patients

This study aimed to evaluate the potential of microRNA (miRNA)-210 as a biomarker for distinguishing iron deficiency anemia (IDA) from functional iron deficiency (FID) in hemodialysis (HD) patients. The diagnostic performance of miRNA-210 was also compared with conventional biochemical markers, including hemoglobin (Hb), ferritin, transferrin saturation (TSAT), and zinc protoporphyrin (ZnPP).

Fifty HD patients were classified into control, IDA, and FID groups according to Hb, ferritin, and TSAT criteria. Pre-dialysis blood samples were collected, and plasma miRNA-210 levels were measured using reverse transcription quantitative polymerase chain reaction (RT²-PCR). Diagnostic performance was assessed through receiver operating characteristic (ROC) analysis alongside traditional biomarkers.

Plasma miRNA-210 levels were significantly higher in the IDA group compared to both the control (p = 0.0010) and FID (p = 0.0007) groups. A significant negative correlation was observed between miRNA-210 and Hb (ρ = -0.363, p = 0.0155). ROC analysis showed that miRNA-210 had moderate diagnostic discriminatory ability for differentiating IDA (AUC = 0.711, p = 0.0186). Its performance was comparable to ZnPP and exceeded to ferritin and TSAT.

miRNA-210 may serve as a supportive biomarker, reflecting the interaction between hypoxia and iron metabolism in distinguishing IDA from FID among HD patients. These findings indicate that miRNA-210 could provide additional value in understanding anemia pathophysiology and enhance diagnostic evaluation.

Key limitations include the small sample size, single-center, cross-sectional design, absence of a healthy control group, and lack of molecular-level functional validation. Larger multicenter studies are needed to confirm these findings and determine clinically relevant cut-off values for miRNA-210.