Objective:To develop a risk nomogram model and validate the predictive value of ultrasound elastography combined with miRNA-130b-3p(miRNA-130b-3p)and miR-146a expression in assessing renal injury among mammary cancer(MC)patients undergoing neoadjuvant chemotherapy.Methods:A total of 130 patients with mammary cancer(MC)who underwent neoadjuvant chemotherapy were selected,and regular blood routine and imaging reviews were conducted.According to the diagnostic and staging cri-teria of Kidney Disease:Improving Global Outcomes(KDIGO),renal injury was statistically analyzed and divided into a renal injury group(n=53)and an MC group(n=77).Clinical data from all patients were collected.Univariate and multivariate Logistic regres-sion analyses were performed to analyze the risk factors for renal injury in MC patients after neoadjuvant chemotherapy,and a nomogram risk prediction model was established and validated.Results:Univariate and multivariate Logistic regression analysis revealed that high-er cortical YM value,medullary YM value,and Emean value,as well as elevated miR-146a(high),mir-130b-3p(high),decreased eG-FR(low),and the presence of combined underlying diseases were risk factors for renal injury in MC patients after neoadjuvant chemo-therapy(P<0.05).The nomogram demonstrated that cortical YM value,medullary YM value,and Emean value were the most influen-tial factors for renal injury after neoadjuvant chemotherapy in MC patients,followed by increased expression of miR-146a and mir-130b-3p.The area under the ROC curve of the nomogram was0.842,with a sensitivity of 83.72%,specificity of 87.0%,and a C-index of 0.816.The H-L goodness-of-fit test results indicated no significant difference between predicted values and actual observed values(P＞0.05).Conclusion:The high YM value of the cortex,as well as the YM and Emean values of the medulla in ultrasound elastogra-phy parameters,along with the elevated expression levels of serum miRNA-130b-3p and miR-146a,serve as significant risk factors for renal injury in patients with mesangial proliferative glomerulonephritis after neoadjuvant chemotherapy.The established nomogram model incorporating these indicators effectively predicts the likelihood of renal injury in such patients.