MicroRNA‐497/fibroblast growth factor‐23 axis, a predictive indictor for decreased major adverse cardiac and cerebral event risk in end‐stage renal disease patients who underwent continuous ambulatory peritoneal dialysis

Abstract

Objective

This study aimed at exploring the correlation of microRNA (miR)‐497/fibroblast growth factor‐23 (FGF‐23) axis with major adverse cardiac and cerebral event (MACCE) occurrence in end‐stage renal disease (ESRD) patients who underwent continuous ambulatory peritoneal dialysis (CAPD).

Methods

Totally, 360 ESRD patients who underwent CAPD were enrolled. Their plasma samples were collected to detect miR‐497 expression by real‐time quantitative polymerase chain reaction, and FGF‐23 level by enzyme‐linked immunosorbent assay. All patients were followed up for 36 months, and the occurrence of MACCE during the follow‐up was documented.

Results

MiR‐497 expression negatively correlated with FGF‐23 level in ESRD patients who underwent CAPD ( P < .001). The MACCE occurrence rate at 1, 2, and 3‐year was 5.6%, 11.9%, and 15.0%, respectively. Furthermore, miR‐497/FGF‐23 axis high level ( P < .001) and miR‐497 high expression ( P = .034) correlated with reduced accumulating MACCE occurrence, whereas FGF‐23 high level ( P = .008) correlated with increased accumulating MACCE occurrence. Forward stepwise multivariate Cox's regression disclosed that miR‐497/FGF‐23 axis high level ( P = .008) was an independent predictive factor for lower accumulating MACCE occurrence, whereas age (≥55 years) ( P < .001), body mass index (≥21.7 kg/m ²) ( P = .006), peritoneal dialysis duration (≥61.0 months) ( P < .001), C‐reactive protein (≥4.7 mg/L) ( P = .001), serum uric acid (≥409.4 μmol/L) ( P = .009), β‐fibrinogen (≥5.8 mmol/L) ( P < .001), and low‐density lipoprotein cholesterol (≥2.7 mmol/L) ( P = .003) were independent factors for predicting higher accumulating MACCE occurrence.

Conclusion

MiR‐497/FGF‐23 axis holds clinical significance for predicting attenuated MACCE risk in ESRD patients who underwent CAPD.