Photo Credit: Ekaterina Chizhevskaya

The following is a summary of “Serum midkine level and its association with subclinical coronary artery calcification and carotid atherosclerosis in chronic kidney disease,” published in the April 2025 issue of BMC Nephrology by Mohamed et al. 

No studies have evaluated midkine (MK) in vascular calcification or vascular calcification (VC) in chronic kidney disease (CKD). 

Researchers conducted a retrospective study to assess serum midkine levels in non-dialysis CKD. They examined its association with carotid atherosclerosis and coronary artery calcification. 

They included 185 CKD stage 3–5 patients and 80 controls, excluding those with acute renal failure, hemodialysis, liver disease, inflammation, anticoagulation, or cancer. They grouped patients by CAC severity and carotid atherosclerosis, assessed CBC, kidney function, lipids, intact parathyroid hormone (iPTH), phosphorus, and measured MK, tumor necrosis factor- α (TNF- α), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) via ELISA; CAC score was calculated by cardiac CT and carotid intima media thickness (CIMT) by carotid ultrasound. 

The results showed all CKD stages had more carotid plaques (P = 0.007, P < 0.001, P < 0.001), higher MK (P < 0.001), and CAC scores (P < 0.001) as CKD worsened. Severe patients with CAC had increased CIMT (P < 0.001), MK (P < 0.001), TNF-α (P = 0.001), IL-6 (P = 0.002), hs-CRP (P = 0.003), iPTH (P= 0.02), phosphorus (P < 0.001), total cholesterol (TC), and low density lipoprotein-cholesterol (LDL-C). CAC was predicted by MK (P = 0.008) and serum creatinine (P = 0.001). Patients with carotid atherosclerotic had higher MK, TNF-α, IL-6, hs-CRP, iPTH, phosphorus, TC, triglycerides, and LDL-C (P < 0.001). MK (P = 0.001), creatinine (P = 0.005), age (P < 0.001), iPTH (P = 0.007), and IL-6 (P = 0.024) predicted carotid atherosclerosis. 

Investigators found that MK levels, carotid atherosclerosis, and CAC increased with CKD severity. They confirmed serum MK as a reliable biomarker for early detection of asymptomatic carotid atherosclerosis and CAC in non-dialysis CKD. 

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-025-04066-7