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Objective   This study aimed to examine a novel microRNA (miR-652-3p) biomarker to improve early diagnosis of acute kidney injury (AKI) in patients with acute decompensated heart failure (ADHF) and to evaluate the survival predictive value of miR-652-3p.Methods   We retrospectively analyzed the data of 196 patients with ADHF, including 65 who developed AKI during hospitalization. Neutrophil gelatinase-associated lipocalin (NGAL) levels were measured in serum and urine samples. Real-time quantitative PCR was applied to evaluate miR-652-3p mRNA expression. The diagnostic performance of miR-652-3p was examined using receiver operating characteristic curve analysis. The prognostic value of miR-652-3p was also analyzed.Results   Serum and urinary NGAL and miR-652-3p levels were elevated in patients with ADHF and AKI. Serum and urinary miR-652-3p expression had diagnostic value in predicting AKI onset in patients with ADHF, and it had improved diagnostic performance when used with NGAL. Patients with AKI and high miR-652-3p levels had a high failure rate of renal recovery and poor 180-day survival.Conclusion   Serum and urinary miR-652-3p may be a candidate biomarker for early diagnosis of AKI in patients with ADHF and for predicting the prognosis of AKI. The combination of NGAL and miR-652-3p may accurately predict AKI onset in ADHF.

Diagnostic and prognostic significance of aberrant miR-652-3p levels in patients with acute decompensated heart failure and acute kidney injury