Midkine as an early biomarker of contrast-induced acute kidney injury in chronic kidney disease patients undergoing percutaneous coronary intervention foracute coronary syndrome: A single-center prospective study

Abstract

BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is an important complication of percutaneous coronary intervention (PCI). AIM: We aimed to study the role of serum midkine (MK) as an early biomarker of CI-AKI. METHODS: We conducted a prospective observational cohort study. It includes 100 chronic kidney disease patients with an estimated glomerular filtration rate <60 ml/min/1.73 m2. All patients were undergoing PCI for acute coronary syndrome (ACS). We measured serum MK before, 2 and 24 h after PCI. RESULTS: The mean age of the patients was 70.3 years, 74% of males. Twenty-seven patients developed CI-AKI. The CI-AKI group has a history of diabetes mellitus and/or dyslipidemia, history of diuretics, metformin, and/or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers use. The CI-AKI patients have low left ventricular ejection fraction (EF < 45%) and low creatinine clearance before PCI. The CI-AKI received more contrast volume, had a longer duration of PCI, and had high Mehran risk score after PCI. Comparison between the two studied groups regarding serum MK showed that there was a statistically significant difference regarding serum MK 2 h after PCI. Receiver operating characteristic curve analysis for serum MK showed that serum MK measured 2 h after PCI was statistically significant to predict CI-AKI. CONCLUSION: An early serum MK after PCI can be used as an early predictor of CI-AKI in ACS patients.