2024-03-29T07:27:23Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00027971
2023-01-16T04:20:13Z
499:500:501
Efficacy of urinary midkine as a biomarker in patients with acute kidney injury
Hayashi, Hiroki
Sato, Waichi
Kosugi, Tomoki
Nishimura, Kunihiro
Sugiyama, Daisuke
Asano, Naoko
Ikematsu, Shinya
Komori, Kimihiro
Nishiwaki, Kimitoshi
Kadomatsu, Kenji
Matsuo, Seiichi
Maruyama, Shoichi
Yuzawa, Yukio
open access
“This is a post-peer-review, pre-copyedit version of an article published in [Clinical and Experimental Nephrology]. The final authenticated version is available online at: http://dx.doi.org/10.1007/s10157-016-1318-0”.
Midkine
Acute kidney injury
Acute tubular necrosis
Biomarker
Background: The mortality and morbidity associated with acute kidney injury (AKI) remains high, despite advances in interventions. A multifunctional heparin-binding growth factor, midkine (MK), is involved in the pathogenesis of ischemic kidney injury. However, the clinical relevance of MK has not yet been elucidated. The present study investigated whether urinary MK can serve as a novel biomarker of AKI. Methods: We initially compared the predictive value of MK with other urinary biomarkers, including N-acetyl-β-d-glucosaminidase (NAG), interleukin (IL)-18, and neutrophil gelatinase-associated lipocalin (NGAL), for the detection and differential diagnosis of established AKI (549 patients). Subsequently, the reliability of MK for the early detection of AKI was prospectively evaluated in 40 patients undergoing elective abdominal aortic aneurysm surgery. Urine samples were obtained at baseline, the period of aortic cross-clamping and declamping, the end of the surgery, and on post-operative day 1. Results: The areas under the receiver operating characteristic curves for the diagnosis of AKI in various kidney diseases were 0.88, 0.70, 0.72, and 0.84 for MK, NAG, IL-18, and NGAL, respectively. When the optimal cutoff value of urinary MK was set at 11.5 pg/mL, the sensitivity and specificity were 0.87 and 0.85, respectively. In the second study, urinary MK peaked at the period of aortic declamping, about 1 h after cross-clamping in patients with AKI. Interestingly, the rise of MK in AKI patients was very precipitous compared with other biomarker candidates. Conclusion: Urinary MK was prominent in its ability to detect AKI and may allow the start of preemptive medication.
First Online: 16 August 2016
Springer
2017-08
eng
journal article
AM
http://hdl.handle.net/2237/00030169
https://nagoya.repo.nii.ac.jp/records/27971
https://doi.org/10.1007/s10157-016-1318-0
1342-1751
1437-7799
Clinical and Experimental Nephrology
21
4
597
607
https://nagoya.repo.nii.ac.jp/record/27971/files/Hayashi_CEN_21_4_597-607.pdf
application/pdf
177.9 kB
2019-05-10