Serum DKK1 Linked to Vasculitis Activity
SERUM levels of Dickkopf related protein 1, also known as DKK1, may help clinicians estimate disease activity in patients with antineutrophil cytoplasmic antibody associated vasculitis, according to a retrospective study of 76 patients. Investigators measured serum DKK1 using blood samples collected at diagnosis and compared levels with established activity indices and laboratory markers.
At baseline, serum DKK1 showed significant correlations with the Birmingham Vasculitis Activity Score and the five factor score, suggesting that higher serum DKK1 may reflect more active systemic disease. Serum DKK1 also correlated with C reactive protein, serum albumin, and serum creatinine, aligning the biomarker with acute phase response and kidney related parameters recorded at presentation.
High Serum DKK1 Predicted ESKD Progression
Beyond cross sectional activity, serum DKK1 at diagnosis was evaluated for its ability to predict adverse outcomes during follow up. Using receiver operating characteristic curve analysis, the investigators identified 3925.0 pg per mL as a cut off value for predicting end stage kidney disease.
Patients with serum DKK1 at or above this threshold had a markedly higher risk of progression to end stage kidney disease, with a reported relative risk of 5.357. They also demonstrated a significantly lower cumulative end stage kidney disease free survival rate compared with those below the cut off, indicating that serum DKK1 could carry prognostic information at the time of diagnosis.
Clinical Implications for AAV Risk Stratification
The authors describe this as the first study to link serum DKK1 at diagnosis with both vasculitis activity and future end stage kidney disease progression in AAV. If validated in larger and prospective cohorts, serum DKK1 could potentially complement clinical scoring systems when clinicians are assessing baseline severity and counseling patients about renal prognosis.
Reference: Kwon HC et al. Usefulness of DKK1 in Estimating Vasculitis Activity and End-Stage Kidney Disease in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Patients. Yonsei Med J. 2026;67(1):9-16.
