miRNA-210 Expression is Associated with Iron Deficiency and Biochemical Parameters in Hemodialysis Patients

Merve Kılıç^1,2*Muhittin Serdar^3,4*Hamad Dheir⁵Mahmud İslam⁶Zafer Ercan⁷

• ¹Department of Anesthesia Program, Advanced Vocational School, Doğuş University, Istanbul, Türkiye
• ²Department of Biochemistry and Molecular Biology, Institute of Health Sciences, Acibadem Universitesi, Istanbul, Türkiye
• ³Acibadem Universitesi Tip Fakultesi, Istanbul, Türkiye
• ⁴Department of Biochemistry and Molecular Biology, Institute of Health Sciences, Istanbul, Turkey, Acibadem Universitesi, Istanbul, Türkiye
• ⁵Department of Nephrology, Sakarya University Faculty of Medicine, Sakarya Universitesi Tip Fakultesi, Sakarya, Türkiye
• ⁶Department of Nephrology, Sakarya University Faculty of Medicine Sakarya, Sakarya Universitesi Tip Fakultesi, Sakarya, Türkiye
• ⁷Department of Nephrology, Sakarya University Training and Research Hospita, Sakarya Universitesi, Sakarya, Türkiye

Background: 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). Methods: 50 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. Results: 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. Conclusion: 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. Limitations: 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.