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KMID : 0338420080230040201
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The Korean Journal of Internal Medicine
2008 Volume.23 No. 4 p.201 ~ p.207
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Polymorphism in the promoter region of the klotho gene (G-395A) is associated with early dysfunction in vascular access in hemodialysis patients
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Kim Young-Su
Jeong Sun-Joo
Lee Hyung-Seok
Kim Eun-Jung
Song Young-Rim
Kim Seong-Gyun
Oh Ji-Eun
Lee Young-Ki
Seo Jang-Won
Yoon Jong-Woo
Koo Ja-Ryong
Kim Hyung-Jik
Noh Jung-Woo
Park Seung-Ho
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Abstract
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Background/Aims: Vascular access dysfunction is an important cause of morbidity and mortality in hemodialysis (HD) patients. Recent studies have shown that a klotho gene mutation is related to endothelial dysfunction, thrombosis, and arteriosclerosis, which are regarded as causes of vascular access dysfunction. We investigated the relationship between the klotho G-395A polymorphism and early dysfunction in vascular access in HD patients.
Methods: Patients who underwent vascular access operations between 1999 and 2002 were enrolled (n=126). Genotyping was performed by allelic discrimination using a 5’-nuclease polymerase chain reaction assay. Clinical data that could be relevant to access dysfunction were obtained from medical records. Early dysfunction of vascular access was defined as the need for any angioplastic or surgical intervention to correct or replace a poorly or nonfunctioning vascular access within 1 year and at least 8 weeks after initial access placement.
Results: Of the 126 patients, the genotype frequency of G-395A was 72.2% for GG (n=91), 24.6% for GA (n=31), and 3.2% for AA (n=4), and the frequency of minor allele was 0.155. Clinical data were similar between the two groups, divided according to the status of the A allele. Early dysfunction occurred in 34 (27.0%) of patients, but it occurred at a significantly higher rate in A allele carriers (45.7%, 16/35) than in noncarriers (19.8%, 18/91; p=0.003).
Conclusions: Our results suggest that the klotho G-395A polymorphism could be a risk factor for early dysfunction of vascular access in HD patients.
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KEYWORD
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Klotho, Arteriovenous access, Hemodialysis
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