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KMID : 1102220160350010042
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Kidney Research and Clinical Practice
2016 Volume.35 No. 1 p.42 ~ p.49
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Assessment of the relationship between serum soluble Klotho and carotid intimaemedia thickness and left ventricular dysfunction in hemodialysis patients
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Emad Abdallah
Osama Mosbah
Ghada Khalifa
Amna Metwaly
Omnia El-Bendary
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Abstract
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Background: The aim of our study was to assess the relationship between soluble Klotho (s-Klotho) and carotid intimaemedia thickness (CIMT) and left ventricular (LV) dysfunction in hemodialysis (HD) patients.
Methods: This is a cross-sectional study conducted on 88 patients with end-stage renal disease on regular HD. Serum levels of calcium, phosphorus, parathyroid hormone, and C-reactive protein were measured. The serum levels of s-Klotho and fibroblast growth factor-23 (FGF-23) were measured using an Enzyme linked immunosorbent assay (ELISA) kit. Echocardiography and measurement of CIMT were also conducted. The studied patients were divided according to the median s- Klotho level into 2 groups: patients with low s-Klotho (Group I) and patients with high s-Klotho (Group II).
Results: Mean value of s-Klotho was significantly low in HD patients compared to controls (P ¼ 0.001), and mean value of FGF-23 was significantly high in HD patients compared to controls (P ¼ 0.001). The mean values of parathyroid hormone, FGF-23, and phosphorus were significantly high in Group I compared to Group II, whereas the mean value of serum calcium was significantly low in Group I compared to Group II. The mean values of CIMT, LV mass (LVM), LVM index, and LV ejection fraction (LVEF) were high in Group I compared to Group II. Patients with low s- Klotho had significantly more coronary artery disease (CAD). In a regression analysis of s-Klotho with different markers of cardiovascular diseases, s-Klotho showed significant association with CIMT, LVEF, and CAD, but not with LVM and LVM index.
Conclusion: The present study showed that patients with a low s-Klotho were more often associated with increased CIMT, LV dysfunction, and CAD, and it seems that there was independent association between s-Klotho and CIMT, LVEF, and CAD.
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KEYWORD
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Cardiovascular diseases, End-stage renal disease, Fibroblast growth factor-23, Soluble Klotho
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