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Kidney Week

Abstract: PO2583

Changes in Serum Klotho in Kidney Transplant Recipients and Prognostic Marker for Allograft Function: A Systematic Review and Meta-Analysis

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Medaura, Juan Antonio, Division of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Thongprayoon, Charat, Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, United States
  • Leeaphorn, Napat, Renal Transplant Program, University of Missouri-Kansas City School of Medicine/Saint Luke's Health System, Kansas City, Missouri, United States
  • Neyra, Javier A., Division of Nephrology, Department of Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, United States
  • Vaitla, Pradeep, Division of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Cabeza Rivera, Franco H., Division of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Mao, Michael A., Department of Medicine, Mayo Clinic, Jacksonville, Florida, United States
  • Cheungpasitporn, Wisit, Division of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
Background

α-Klotho protein is a well-known anti-aging factor that regulates systemic phosphate metabolism. Mutation of klotho in mice can lead to phenotypes resembling human aging. Since klotho expression is highest in the kidney, patients with advanced chronic kidney disease have progressive decline in klotho levels. However, changes in serum klotho levels in kidney transplant (KTx) patients and its prognostic significance on allograft function remain unclear.

Methods

A literature search was conducted using MEDLINE, EMBASE and Cochrane Database from inception through October 2019 to identify studies evaluating 1) change in serum klotho levels after KTx, 2) klotho levels among KTx vs non-KTx patients, and 3) prognostic significance of klotho levels on allograft function after KTx. Study results were pooled and analyzed utilizing random-effects model.

Results

10 cohort studies with a total of 431 KTx patients were identified. After KTx, there was significant increase in serum klotho levels (at 4 to 13 months post-KTx) with mean difference (MD) of 243.11 (3 studies; 95%CI 67.41 to 418.81). Although KTx patients had lower serum klotho level with MD of = -234.50 (5 studies; 95%CI -444.84 to -24.16) compared to healthy volunteers, a study demonstrated comparable klotho level between KTx patients and eGFR-matched controls. Two studies demonstrated high serum klotho levels in deceased donors as prognostic marker for good allograft function within 1 year after KTx (p<0.05).

Conclusion

There is a significant increase in serum klotho levels after KTx. There is potential role of klotho levels as prognostic marker for renal allograft function.