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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
The association between soluble klotho and cardiovascular parameters in chronic kidney disease: results from the
Hyo Jin Kim1, Eunjeong Kang2, Yun Kyu Oh2
1Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju-si, Gyeongsangbuk-do, South Korea.
Insights
Serum klotho levels are linked to reduced left ventricular hypertrophy in chronic kidney disease (CKD) patients. However, klotho did not show a significant association with arterial stiffness in this cohort.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Klotho, a protein associated with aging, plays a role in mineral bone metabolism.
- Klotho may link chronic kidney disease (CKD) and cardiovascular disease (CVD).
Purpose of the Study:
- Investigate the association between serum klotho levels and cardiac parameters in a large Korean CKD cohort.
- Explore klotho's role in cardiovascular complications of CKD.
Main Methods:
- Analyzed 2101 participants from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD).
- Measured serum klotho levels, left ventricular mass index (LVMI) for hypertrophy, and brachial-to-ankle pulse wave velocity (baPWV) for arterial stiffness.
- Utilized multivariable linear regression models for association analysis.
Main Results:
- Lower serum klotho levels were observed in advanced CKD stages.
- Higher serum klotho levels were significantly associated with decreased LVMI.
- Serum klotho showed a significant inverse association with LVMI (β = -0.04).
- No significant association was found between serum klotho and baPWV after adjustment.
Conclusions:
- Serum klotho is an independent biomarker for left ventricular hypertrophy in CKD patients.
- Serum klotho is not significantly associated with arterial stiffness in this cohort.
Background:
Klotho, a protein linked to aging, has emerged as a pivotal player in mineral bone metabolism and might explain the relationship between chronic kidney disease (CKD) and cardiovascular disease (CVD). The present study aimed to investigate the association between serum klotho and cardiac parameters from a large-scale Korean CKD cohort.
Methods:
We analyzed 2101 participants from KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) cohort who had been measured for serum klotho levels. Left ventricular hypertrophy evaluated by left ventricular mass index (LVMI) and arterial stiffness measured by brachial-to-ankle pulse wave velocity (baPWV) were explored as cardiovascular parameters.
Results:
Patients were 53.6 ± 12.2 years old and 61.1% were male. The mean estimated glomerular filtration rate (eGFR) was 53.0 ± 30.7 mL/min/1.73m2. The median serum klotho level was 536 (interquartile range [IQR]: 420-667) pg/mL. Advanced CKD stages were associated with lower serum klotho levels (P < 0.001, P for linear trend < 0.001). Ascending quartiles of klotho were significantly associated with decreased LMVI (P < 0.001, P for linear trend< 0.001). A multivariable linear regression model showed serum klotho had a significant inverse association with LVMI (β - 0.04; 95% CI [confidence interval] -0.004, - 0.00007; P = 0.041). However, there was no significant association between serum klotho and baPWV after adjustment (β 0.003; 95% CI -0.04, 0.05; P = 0.876).
Trial Registration:
This trial was registered on ClinicalTrials.gov on 28 June 2012 ( NCT01630486 ).
Conclusions:
Serum klotho was an independent biomarker of LVMI, but not arterial stiffness.
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