Study on correlation between serum Klotho protein level with vascular calcification in patients with chronic kidney disease / 重庆医学

ABSTRACT

Objective To investigate the correlation between serum Klotho protein level with vascular calcification in the pa-tients with chronic kidney disease (CKD) .Methods One hundred and seven inpatients with CKD in the nephrology department of the hospital from January 2014 to December 2014 were selected and 20 age-and sex-matched persons undergoing healthy physical examination served as the control group .Serum Klotho ptotein level was measured by ELISA .Abdominal aortic calcification(AAC) was assessed by abdominal lateral X-rays .Meanwhile the brachial arterial flow-mediated dilatation (FMD) and carotid intima-media thickness (cIMT) were determined by the color Doppler ultrasound .The difference of serum Klotho protein levels were compared between the CKD patients and healthy people .The relationship between the serum Klotho protein level with CKD-mineral and bone disorder (CKD-MBD) and vascular dysfunction such as vascular calcification ,.endothelial dysfunction and cIMT was investigated and its clinical significance was analyzed .Results Serum Klotho protein level and FMD in the CKD group were significantly lower than those in the control group ,while the cIMT and AAC scores were significantly higher than those in the control group .Serum Klotho level was significantly decreased along with the progression of CKD .Serum Klotho protein level were negatively correlated with the age(r= -0 .348 ,P< 0 .01) ,log iPTH (r= -0 .366 ,P< 0 .01) ,cIMT (r= -0 .192 ,P< 0 .05) and AAC score (r= -0 .251 ,P<0 .01) ,and positively correlated with eGFR (r=0 .387 ,P<0 .01) ,1 ,25-dihydroxyvitamin D3 level (r=0 .311 ,P<0 .01) and FMD (r=0 .190 ,P<0 .05) in the CKD patients .The Klotho protein level in the patients with FMD ≥6 .0 ,cIMT<1 .0 mm and AAC score=0 were significantly higher than those in the patients with FMD <6 .0 ,cIM T≥1 .0 mm and AAC score >0 . The multivariate Logistic regression analysis showed that age (OR=3 .63 ,95% CI1 .75 -8 .89 ,P=0 .002) ,MBP (OR=2 .98 , 95% CI1 .45-7 .69 ,P=0 .009) ,albuminuria (OR= 1 .97 ,95% CI1 .16 -3 .73 ,P= 0 .022) ,serum Klotho protein level (OR=0 .60 ,95% CI0 .39-0 .98 ,P=0 .007) were the independent predictive factors of vascular calcification .Conclusion Serum Klotho protein level in the CKD patients is significantly decreased along with CKD progression ;serum Klotho protein level decrease is an independent predictive factor of vascular calcification .