Abstract
Background: Klotho is a protein with multiple biological functions in various organs, particularly the kidneys. In the proximal tubule, Klotho acts as a co-receptor for fibroblast growth factor 23 (FGF23), regulating phosphate and vitamin D metabolism. In the distal tubule, Klotho enhances calcium and sodium reabsorption. Serum Klotho originates from the kidneys, and its levels decrease with declining renal function. Studies indicate that serum Klotho levels progressively decrease with lower glomerular filtration rate (GFR) in chronic kidney disease (CKD), but differences across CKD stages remain controversial. Currently, there are no published data on serum Klotho levels in CKD patients in Vietnam.
Objectives: To determine serum Klotho levels in CKD and investigate their relationship with GFR and selected biochemical parameters.
Materials and method: A cross-sectional, case-control study was conducted with 153 CKD patients and 60 healthy controls. Serum Klotho levels were measured using enzyme-linked immunosorbent assay (ELISA). Levels of blood urea, creatinine, hemoglobin, albumin, calcium, phosphate, parathyroid hormone (PTH), and 25-hydroxy vitamin D were analyzed using an automated biochemical analyzer.
Results: The median serum Klotho level in CKD patients was 386.43 pg/ml, significantly lower than in the control group (549.28 ± 175.31 pg/ml, P<0.05). The mean serum Klotho levels in CKD stages 1, 2, 3, 4, and 5 were 497.95 ± 151.32, 490.46 ± 183.16, 388.23 ± 120.53, 333.21 ± 97.37, and 317.97 ± 127.04 pg/ml, respectively. A significant decline in serum Klotho was observed from CKD stage 3 compared to controls (P<0.001). Serum Klotho showed a moderate negative correlation with urea (r=-0.393, P<0.001), creatinine (r=-0.463, P<0.001), and serum PTH (r=-0.383, P<0.001), while a moderate positive correlation was observed with GFR (r=0.451, P<0.001) and hemoglobin (r=0.312, P<0.001). Multivariate regression analysis identified GFR as the only independent predictor of serum Klotho levels (β coefficient = 1.916, P<0.001).
Conclusions: Serum Klotho levels decrease in CKD, with a significant decline from stage 3, and are associated with GFR. Further studies are needed to evaluate the potential role of Klotho as an early biomarker for CKD.
| Published | 2025-04-24 | |
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| Issue | Vol. 15 No. 1 (2025) | |
| Section | Original Articles | |
| DOI | 10.34071/jmp.2025.1.21 | |
| Keywords | Klotho, mức lọc cầu thận, bệnh thận mạn Klotho, glomerular filtration rate, chronic kidney disease |
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Copyright (c) 2025 Hue Journal of Medicine and Pharmacy
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