Association between Serum Soluble Klotho Levels and Mortality in Chronic Hemodialysis Patients

被引:41
作者
Otani-Takei, Naoko [1 ]
Masuda, Takahiro [1 ]
Akimoto, Tetsu [1 ]
Honma, Sumiko [2 ]
Watanabe, Yuko [1 ]
Shiizaki, Kazuhiro [3 ]
Miki, Takuya [1 ]
Kusano, Eiji [1 ]
Asano, Yasushi [2 ]
Kuro-o, Makoto [3 ]
Nagata, Daisuke [1 ]
机构
[1] Jichi Med Univ, Dept Internal Med, Div Nephrol, Shimotsuke, Tochigi 3290498, Japan
[2] Japanese Red Cross Koga Hosp, Dept Nephrol, Koga, Ibaraki, Japan
[3] Jichi Med Univ, Ctr Mol Med, Div Antiaging Med, Shimotsuke, Tochigi 3290498, Japan
关键词
FIBROBLAST GROWTH FACTOR-23; HEALTH-CARE PROFESSIONALS; CARDIOVASCULAR EVENTS; PLASMA KLOTHO; OXIDATIVE STRESS; SECRETED KLOTHO; HEART-FAILURE; ALPHA-KLOTHO; KIDNEY; PROTEIN;
D O I
10.1155/2015/406269
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Klotho is a single-pass transmembrane protein predominantly expressed in the kidney. The extracellular domain of Klotho is subject to ectodomain shedding and is released into the circulation as a soluble form. Soluble Klotho is also generated from alternative splicing of the Klotho gene. In mice, defects in Klotho expression lead to complex phenotypes resembling those observed in dialysis patients. However, the relationship between the level of serum soluble Klotho and overall survival in hemodialysis patients, who exhibit a state of Klotho deficiency, remains to be delineated. Here we prospectively followed a cohort of 63 patients with a mean duration of chronic hemodialysis of 6.7 +/- 5.4 years for a median of 65 months. Serum soluble Klotho was detectable in all patients (median 371 pg/mL, interquartile range 309-449). Patients with serum soluble Klotho levels below the lower quartile (<309 pg/mL) had significantly higher cardiovascular and all-cause mortality rates. Furthermore, the higher all-cause mortality persisted even after adjustment for confounders (hazard ratio 4.14, confidence interval 1.29-13.48). We conclude that there may be a threshold for the serum soluble Klotho level associated with a higher risk of mortality.
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页数:10
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