Midkine as a novel biomarker for contrast-induced acute kidney injury

Abstract

Contrast-induced acute kidney injury (CI-AKI) is an intrinsic kidney injury caused by contrast injection in susceptible individuals. Although the pathophysiological mechanisms by which contrast agents induce kidney injury have not been completely explained, direct and indirect effects, as well as hemodynamic perturbations, have been suggested. Renal effects develop immediately after contrast injection, and, theoretically, they could be detected early by using a sensitive biomarker. Recently, studies have been conducted to determine specific biomarkers to guide the early diagnosis of CI-AKI and thus improve the outcomes of these patients. Midkine (MK) is a heparin-binding growth factor that balances cell growth, survival, and migration. It has an antiapoptotic activity in nephrogenesis. Midkine has been investigated as an early biomarker for CI-AKI in patients undergoing percutaneous coronary intervention (PCI) for stable angina and was significantly higher in CI-AKI patients post PCU. However, more studies are needed to validate its efficacy in the early detection of CI-AKI.

Keywords: Contrast-induced nephropathy, contrast-induced acute kidney injury, midkine, biomarker.