ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO193

Soluble Klotho Is Associated with Cardiovascular Disease Events in Patients with Hemodialysis: Prospective Cohort Study

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Nakashima, Akio, Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
  • Ohkido, Ichiro, Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
  • Yokoyama, Keitaro, Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
  • Yokoo, Takashi, Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
Background

Patients with hemodialysis are higher mortality and their main cause of death is CVD events.
Mineral bone disorder recently has been regarded as the important risk factors of CVD events.
Klotho, which is known as an antiaging gene, serves as the cofactor for fibro blast growth factor 23 (FGF23) and regulate phosphorus and vitamin D metabolism. We aimed to evaluate whether serum soluble klotho levels are associated with CVD events in hemodialysis patients.

Methods

This prospective cohort study analyzed 1029 hemodialysis patients. We divided the study population into four groups based on serum Klotho levels. In this study, we defined the primary outcome was cardiovascular events, defined as a composite of death due to cardiac disease, sudden death, ischemic heart disease, heart failure requiring hospitalization and cerebral vascular events including cerebral hemorrhage and cerebral infarction. Association between Klotho levels and CVD events were analyzed using Cox proportional hazard model.

Results

The median soluble Klotho level was 305.9 (233.4-400.6) pg/ml. Their mean age (±standard deviation) was 63.1 (±11.9) years and median dialysis vintage was 109 (38-153) months. During follow up, 394 CVD events occurred. CVD events were more frequent in the lowest than highest soluble Klotho quartile [hazard ratio, 1.50; 95% confidence interval, 1.04-2.18; P-value, 0.032]. These associations were confirmed in patients with higher age (>65 years), higher phosphate levels (> 6.0mg/dl) , or cinacalcet.

Conclusion

In this study, we found that soluble klotho is associated with CVD events in hemodialysis patients.