title: The role of midkine in the inflammatory process and its correlation with other inflammatory markers in renal transplant recipients.
abstract: BACKGROUND
  Midkine (MK), which is expressed in the proximal tubular epithelial cells of the kidney, is thought to have a role in the pathophysiology of inflammation-related renal diseases. Both immunological and nonimmunological mechanisms may affect renal functions negatively during the early and late post-transplantation periods. We aimed in our study to evaluate the relationship of MK with clinical findings and inflammatory markers, including high sensitivity C-reactive protein (hs-CRP), interleukin (IL-6) and tumor necrosis factor (TNF-α) in the pretransplant and post-transplant period.
  
  
  METHODS
  Forty-one consecutive patients transplanted from living related donors were included in this prospective observational study. All patients received the same immunosuppressive treatment protocol. MK, hsCRP, IL-6 and TNF-α levels were measured before and 2 months after renal transplantation.
  
  
  RESULTS
  Pretransplant MK levels correlated positively with hsCRP (r = 0.41, p = 0.004) and IL-6 (r = 0.58, p&lt;0.001). The mean post-transplant MK level was found to be higher than the pretransplant level (143 ± 350 pg/mL, 2792 ± 4235 pg/mL respectively, p = &lt;0.001), while the mean hsCRP, IL-6 and TNF-α levels did not change significantly. Post-transplant IL-6 correlated significantly with MK (r = 0.388, p = 0.012), hsCRP (r = 0.41, p = 0.007) and TNF-α (r = 0.348, p = 0.026). There was no significant correlation between clinical findings and inflammatory markers.
  
  
  CONCLUSIONS
  MK may be a good inflammatory marker in renal transplant recipients as in other inflammatory diseases. Moreover, it seems that it is not affected by factors other than inflammation during the post-transplantation period.
authors.affiliation: Department of Nephrology, Haseki Training and Research Hospital, Istanbul - Turkey.
authors.forename: Sami
authors.initials: S
authors.lastname: Uzun
authors.affiliation: Department of Internal Diseases, Haseki Training and Research Hospital, Istanbul - Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Kaya
authors.affiliation: Department of Internal Diseases, Haseki Training and Research Hospital, Istanbul - Turkey.
authors.forename: Kenan
authors.initials: K
authors.lastname: Celik
authors.affiliation: Department of Nephrology, Haseki Training and Research Hospital, Istanbul - Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Behlul
authors.affiliation: Department of Nephrology, Haseki Training and Research Hospital, Istanbul - Turkey.
authors.forename: Oktay
authors.initials: O
authors.lastname: Ozkan
authors.affiliation: Department of Nephrology, Haseki Training and Research Hospital, Istanbul - Turkey.
authors.forename: Melike
authors.initials: M
authors.lastname: Kuvvet
authors.affiliation: Department of Biochemistry, Haseki Education and Research Hospital, Istanbul - Turkey.
authors.forename: Yasemin Erdogan
authors.initials: YE
authors.lastname: Doventas
authors.affiliation: Department of Nephrology, Bezmialem University Medical Faculty, Istanbul - Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Gursu
authors.affiliation: Department of Nephrology, Haseki Training and Research Hospital, Istanbul - Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Karadag
authors.affiliation: Department of Nephrology, Haseki Training and Research Hospital, Istanbul - Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Sumnu
authors.affiliation: Department of Nephrology, Haseki Training and Research Hospital, Istanbul - Turkey.
authors.forename: Egemen
authors.initials: E
authors.lastname: Cebeci
authors.affiliation: Transplantation Unit, Memorial Sisli Hospital, Istanbul - Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Kocak
authors.affiliation: Department of Nephrology, Istanbul University Istanbul Medical Faculty, Istanbul - Turkey.
authors.forename: Aydın
authors.initials: A
authors.lastname: Turkmen
authors.affiliation: Department of Nephrology, Haseki Training and Research Hospital, Istanbul - Turkey.
authors.forename: Savas
authors.initials: S
authors.lastname: Ozturk
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007249:Inflammation / Q000097:blood*; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D000078792:Midkine; D011446:Prospective Studies; D066027:Transplant Recipients; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015415:Biomarkers; D016207:Cytokines; D007166:Immunosuppressive Agents; D018836:Inflammation Mediators; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D000078792:Midkine; D002097:C-Reactive Protein