CHAPTER 5: Regulation and Function of MicroRNAs in Kidney Diseases

Chronic kidney disease (CKD) is a major public health issue of growing epidemic dimensions. It leads to the progressive deterioration of renal function, requiring expensive and debilitating renal replacement therapies such as dialysis and transplantation. The costs of CKD are unsustainable for health systems, even in developed countries. Current therapeutic options, such as angiotensin converting enzyme inhibitors, which aim to reduce the need for dialysis and transplantation, are not invariably effective. To find new therapeutics, a better understanding of CKD pathomechanisms is imperative. Several lines of research have focused on microRNAs (miRNAs) that, due to their capacity of regulating gene expression post-transcriptionally, have been increasingly recognized to have a key role in CKD. miRNAs can simultaneously inhibit many different messenger RNAs (mRNAs), amplifying biological responses. Hence, miRNAs could serve both as reliable biomarkers for the diagnosis and prognosis of CKD, and as attractive targets for therapeutic regulation. Here, we provide an overview of current studies of cell-specific miRNA contributions to CKD. We also discuss the challenges of designing safe and targeted miRNA therapeutics delivery and efficacy.