Introduction:
Soluble alpha Klotho ( s.Klotho ) is an emerging marker for chronic kidney disease ( CKD) prognosis. The objective was to study the association between s.Klotho and CKD-related decrease in glomerular filtration rate (GFR) , bone and vascular damage. Primary endpoints like 40% or more fall in GFR, a requirement for renal replacement therapy (RRT) , and death with different grades of s.Klotho deficiency was studied.
Methods:
118 patients with CKD stage 2-4 were enrolled . Clinical and laboratory parameters were recorded at time of enrolment, 6 months and 12 months .107 patients continued in the study. A double sandwich ELISA for s.Klotho was recorded in controls (n = 25) and patients’ serum samples at 6 months (n=107) and 12 months (n=102) .
Results:
Of the 107 patients ( 80 male , 27 female) mean s.Klotho was 3.46 ng/ml (02.3 - 04.2). The GFR fall was significantly different (p-value < 0.0001) in the different grades of s. Klotho deficiency with Grade 4 s. Klotho deficiency (0.1 to 2.99 ng/ml) having the maximum fall of GFR at 9.2 ml/min/1.73 m2 (04.8 - 12.0) and minimum in Grade 2 (3 – 5.99 ng/ml) 1.35 ml/min/1.73 m2 (03.0 - 02.75). Ankle Brachial Pressure Index positively correlated with s. Klotho Correlation Coefficient is 0.536 (0.382–0.662) (p<0.001). The Carotid Intimal Medial Thickness negatively correlated with s. Klotho and correlation coefficient was -0.712 (95% CI -0.797 to -0.601, p < 0.001).
All five deaths had s.Klotho Grade 4 (severe ) deficiency . Event-free survival rate was maximum (100%) in grade 2 Klotho deficiency and lowest (55 %) in grade 4 s. Klotho deficiency.
Conclusions:
s.Klotho levels decreased significantly in patients with progressive kidney failure. s. Klotho levels significantly correlated with the presence of vascular disease. Death, and need for RRT was significantly more in patients with severe s.Klotho deficiency.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.