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). 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

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... osorbent assay. All patients were followed up for 36 months, and the occurrence of MACCE during the follow-up was documented. 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/m2 ) (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. MiR-497/FGF-23 axis holds clinical significance for predicting attenuated MACCE risk in ESRD patients who underwent CAPD.