Urinary miR-4639 and miR-210 differed significantly in IgA patients compared to MN, DN, MCN and HCs, and miR-4639 and miR-210 were even significantly different between patients with progressive IgAN vs. non-progressive IgAN (p < 0.05).Exosomal miR-4639 and miR-210 were linked to eGFR and proteinuria, respectively, in plasma (r = −0.5424, p < 0.0001 and r = −0.4801, p = 0.0001) and urine (r = 0.7725 and r = 0.6010, both p < 0.0001) Plasma exosomal miR-4639 and miR-210 performed better than proteinuria (g/24 h) to predict kidney outcomes (AUC = 0.77 and AUC = 0.79–0.83, respectively). The gene discussed is CD79A; the disease is liver dysplastic nodule.