Objective The study commits to probing the clinical expression of microRNA‐144‐5p (miR‐144‐5p) and its modulatory effect on the renal function of uremia. Methods Levels of blood urea nitrogen (BUN), β2‐microglobulin (β2‐MG), serum creatinine (Scr), blood calcium (Ca), phosphorus (P), and intact parathyroid hormone (iPTH) and miR‐144‐5p expression in serum of uremia patients were detected. The correlation among miR‐144‐5p expression with BUN, β2‐MG, Scr, Ca, P, and iPTH levels in uremic patients was analyzed. The rats were injected with miR‐144‐5p agomir to detect the change of BUN, Scr, β2‐MG, Scr, Ca, P, and iPTH levels in uremic rats. Results miR‐144‐5p expression in uremic patients was negatively correlated with BUN, Scr, β2‐MG, P, and iPTH levels, and positively correlated with free Ca concentration in blood. miR‐144‐5p elevation reduced BUN, Scr, β2‐MG, P, and iPTH levels, and increased free Ca concentration in blood in uremic rats. Conclusion miR‐144‐5p is lowly expressed, and miR‐144‐5p has a regulatory effect on renal function in uremia.