Soluble average Klotho level as a prognostic marker for acute kidney injury outcomes: a 90-day follow-up study

Klotho is highly expressed in the kidney and confers pleiotropic kidney protective effects. This study aimed to assess the soluble average Klotho level and its relationship to renal function and outcomes in participants with acute kidney injury (AKI).

We recruited 102 participants with AKI and 30 healthy controls (HCs). For patients with AKI, serum soluble (sKlotho) levels upon admission to and discharge from hospital were measured to assess the relationship between sKlotho level and kidney function. Individuals with AKI were followed up for 90 days to determine the association between their average sKlotho level and short-term AKI outcomes.

The baseline sKlotho level in individuals with AKI at admission was significantly lower than that in HCs. For individuals with AKI, the sKlotho level was significantly lower in stage 3 than in stage 1 or 2. The sKlotho level was restored along with renal function improvement at discharge. During follow-up, a lower average, but not baseline, sKlotho level, or average sKlotho/creatinine ration predicted more AKI clinical outcomes.

The sKlotho level decreased significantly with kidney injury and represented severity. The average sKlotho level inversely correlated with detrimental kidney outcomes and may have potential diagnostic and predictive roles in AKI.