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Abstract: SA-PO167

Association of Serum Klotho and Risks of Fractures and Osteoporosis in Patients With and Without CKD

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical


  • Chewcharat, Api, Mount Auburn Hospital, Cambridge, Massachusetts, United States
  • Nigwekar, Sagar U., Massachusetts General Hospital, Boston, Massachusetts, United States

Serum soluble Klotho (sKlotho) levels are associated with bone abnormalities in animal models. The extension of these findings to clinical bone outcomes in humans, however, remains controversial.


We conducted a cross-sectional study among 8,660 US adults aged 40-79 years old in the National Health and Nutrition Examination Survey (NHANES) 2007-2010 and 2013-2014. Fractures were identified based on self-reported hip, wrist, or spine fractures diagnosed by doctors on standardized questionnaires. Osteoporosis was defined as T-score ≤ −2.5 at either femoral neck or lumbar spine. sKlotho was divided into 4 quartiles. We examined the association between sKlotho and risks of fractures and osteoporosis using weighted multivariable logistic regression among participants with and without chronic kidney disease (CKD)


Of 8,660 US adults aged 40-79 years old (847 participants with CKD and 7,813 participants without CKD), 1,042 participants reported history of fractures in either hip, wrist, or spine. Among those who reported a history of fractures, 113 participants were with CKD and 929 participants were without CKD. Median sKlotho among participants with a history of fractures was 788.9 pg/ml vs 804.9 pg/ml among those without a history of fractures. Among non-CKD participants, there was no association between the quartile of sKlotho and the risk of fractures (OR highest vs lowest quartile 0.95, 95%CI [0.75, 1.19], p = 0.64) after adjusting for confounders. Among participants with CKD, after adjusting for confounders, there was no association between the quartile of sKlotho and the risk of fractures (OR highest vs lowest quartile 0.65, 95%CI [0.35, 1.19], p = 0.15) (Table 1). There were no associations between sKlotho and risk of osteoporosis among either CKD or non-CKD (Table 2).


sKlotho does not appear to be a predictor of fractures or osteoporosis in either CKD or non-CKD participants.