TY - JOUR
T1 - Association between soluble klotho and change in kidney function
T2 - The health aging and body composition study
AU - Drew, David A.
AU - Katz, Ronit
AU - Kritchevsky, Stephen
AU - Ix, Joachim
AU - Shlipak, Michael
AU - Gutiérrez, Orlando M.
AU - Newman, Anne
AU - Hoofnagle, Andy
AU - Fried, Linda
AU - Semba, Richard D.
AU - Sarnak, Mark
N1 - Publisher Copyright:
© 2017 by the American Society of Nephrology.
PY - 2017/6
Y1 - 2017/6
N2 - CKD appears to be a condition of soluble klotho deficiency. Despite known associations between low soluble klotho levels and conditions that promote kidney damage, such as oxidative stress and fibrosis, little information exists regarding the longitudinal association between soluble klotho levels and change in kidney function. We assayed serum soluble a-klotho in 2496 participants within the Health Aging and Body Composition study, a cohort of older adults. The associations between soluble klotho levels and decline in kidney function (relative decline: EGFR decline $30%; absolute decline: EGFR decline .3 ml/min per year) and incident CKD (incident EGFR ,60 ml/min per 1.73 m2 and .1 ml/min per year decline) were evaluated. We adjusted models for demographics, baseline EGFR, urine albumin-To-creatinine ratio, comorbidity, and measures of mineral metabolism. Among participants, the mean (SD) age was 75 (3) years, 52% were women, and 38% were black. Median (25th, 75th percentiles) klotho level was 630 (477, 817) pg/ml. In fully adjusted models, each two-fold higher level of klotho associated with lower odds of decline in kidney function (odds ratio, 0.78 [95% confidence interval, 0.66 to 0.93] for 30%decline in EGFR, and 0.85 [95% confidence interval, 0.73 to 0.98] for.3ml/min per year decline in EGFR), but not of incident CKD (incident rate ratio, 0.90 [95% confidence interval, 0.78 to 1.04]). Overall, a higher soluble klotho level independently associated with a lower risk of decline in kidney function. Future studies should attempt to replicate these results in other cohorts and evaluate the underlying mechanism.
AB - CKD appears to be a condition of soluble klotho deficiency. Despite known associations between low soluble klotho levels and conditions that promote kidney damage, such as oxidative stress and fibrosis, little information exists regarding the longitudinal association between soluble klotho levels and change in kidney function. We assayed serum soluble a-klotho in 2496 participants within the Health Aging and Body Composition study, a cohort of older adults. The associations between soluble klotho levels and decline in kidney function (relative decline: EGFR decline $30%; absolute decline: EGFR decline .3 ml/min per year) and incident CKD (incident EGFR ,60 ml/min per 1.73 m2 and .1 ml/min per year decline) were evaluated. We adjusted models for demographics, baseline EGFR, urine albumin-To-creatinine ratio, comorbidity, and measures of mineral metabolism. Among participants, the mean (SD) age was 75 (3) years, 52% were women, and 38% were black. Median (25th, 75th percentiles) klotho level was 630 (477, 817) pg/ml. In fully adjusted models, each two-fold higher level of klotho associated with lower odds of decline in kidney function (odds ratio, 0.78 [95% confidence interval, 0.66 to 0.93] for 30%decline in EGFR, and 0.85 [95% confidence interval, 0.73 to 0.98] for.3ml/min per year decline in EGFR), but not of incident CKD (incident rate ratio, 0.90 [95% confidence interval, 0.78 to 1.04]). Overall, a higher soluble klotho level independently associated with a lower risk of decline in kidney function. Future studies should attempt to replicate these results in other cohorts and evaluate the underlying mechanism.
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U2 - 10.1681/ASN.2016080828
DO - 10.1681/ASN.2016080828
M3 - Article
C2 - 28104822
AN - SCOPUS:85021637482
SN - 1046-6673
VL - 28
SP - 1859
EP - 1866
JO - Journal of the American Society of Nephrology
JF - Journal of the American Society of Nephrology
IS - 6
ER -