Serum Klotho in Living Kidney Donors and Kidney Transplant Recipients: A Meta-Analysis

Journal of Clinical Medicine

Saraschandra Vallabhajosyula¹  Tarun Bathini²  Panupong Hansrivijit³  Wisit Kaewput⁴  MichaelA. Mao⁵  Api Chewcharat⁶  Charat Thongprayoon⁶  JavierA. Neyra⁷  NarothamaReddy Aeddula⁸  PaulW. Davis⁹  Juan Medaura⁹  Wisit Cheungpasitporn⁹  SohailAbdul Salim⁹  Napat Leeaphorn^1,10 

[1] Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA;Department of Internal Medicine, University of Arizona, Tucson, AZ 85721, USA;Department of Internal Medicine, University of Pittsburgh Medical Center Pinnacle, Harrisburg, PA 17105, USA;Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok 10400, Thailand;Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL 32224, USA;Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA;Division of Nephrology, Bone and Mineral Metabolism, Department of Internal Medicine, University of Kentucky, Lexington, KY 40506, USA;Division of Nephrology, Department of Medicine, Deaconess Health System, Evansville, IN 47710, USA;Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA;Renal Transplant Program, University of Missouri-Kansas City School of Medicine/Saint Luke’s Health System, Kansas City, MO 64110, USA;

关键词: klotho;    α-Klotho;    FGF-23;    kidney transplantation;    kidney donor;    renal transplantation;   

DOI  :  10.3390/jcm9061834

来源: DOAJ

【 摘 要 】

α-Klotho is a known anti-aging protein that exerts diverse physiological effects, including phosphate homeostasis. Klotho expression occurs predominantly in the kidney and is significantly decreased in patients with chronic kidney disease. However, changes in serum klotho levels and impacts of klotho on outcomes among kidney transplant (KTx) recipients and kidney donors remain unclear. A literature search was conducted using MEDLINE, EMBASE, and Cochrane Database from inception through October 2019 to identify studies evaluating serum klotho levels and impacts of klotho on outcomes among KTx recipients and kidney donors. Study results were pooled and analyzed utilizing a random-effects model. Ten cohort studies with a total of 431 KTx recipients and 5 cohort studies with a total of 108 living kidney donors and were identified. After KTx, recipients had a significant increase in serum klotho levels (at 4 to 13 months post-KTx) with a mean difference (MD) of 243.11 pg/mL (three studies; 95% CI 67.41 to 418.81 pg/mL). Although KTx recipients had a lower serum klotho level with a MD of = −234.50 pg/mL (five studies; 95% CI −444.84 to −24.16 pg/mL) compared to healthy unmatched volunteers, one study demonstrated comparable klotho levels between KTx recipients and eGFR-matched controls. Among kidney donors, there was a significant decrease in serum klotho levels post-nephrectomy (day 3 to day 5) with a mean difference (MD) of −232.24 pg/mL (three studies; 95% CI –299.41 to −165.07 pg/mL). At one year following kidney donation, serum klotho levels remained lower than baseline before nephrectomy with a MD of = −110.80 pg/mL (two studies; 95% CI 166.35 to 55.24 pg/mL). Compared to healthy volunteers, living kidney donors had lower serum klotho levels with a MD of = −92.41 pg/mL (two studies; 95% CI −180.53 to −4.29 pg/mL). There is a significant reduction in serum klotho levels after living kidney donation and an increase in serum klotho levels after KTx. Future prospective studies are needed to assess the impact of changes in klotho on clinical outcomes in KTx recipients and living kidney donors.

【 授权许可】

Unknown