Test cohort: 25 miRNAs were significantly downregulated in IMN patients (p < 0.05).Validation cohort: significant correlations between miR-9-5p and triglyceride levels and eGFR, whereas miR-30b-5p revealed a significant relationship with the levels of anti-PLA2R, serum albumin, B2M, and the ratio of GS/GN. According to ROC analysis, exosomal miR-30b-5p and miR-9-5p also seemed to have a good diagnostic value in IMN patients (p < 0.05, AUC = 0.867 and 0.724, respectively). This evidence concerns the gene B2M and ganglioneuroma.