Khalid J. Al-Jewari Department of Chemistry and Biochemistry, College of Medicine, Al-Nahrain University, Baghdad, Iraq
Jawad K. Manuti Department of Medicine, College of Medicine, Al-Nahrain University, Baghdad, Iraq
chronic kidney disease, CDK, eGFR, soluble alpha-Klotho, urinary alpha-Klotho
Background: Chronic kidney disease is an epidemic global health problem that leads to death. To prevent any disease progression and treatment, the diagnosis must be made in the early stage by studying renal damage. Klotho is a protein found in many organs of the human body, but it is mainly abundant in the kidney.
Objectives: This study is aimed to evaluate klotho's clinical significance as an additional biomarker for diagnosing chronic kidney disease in its early stages.
Methods: One hundred subjects were included in this study to measure their serum and urinary klotho. Forty patients with chronic kidney disease (pre-dialysis) and sixty normal subjects were enrolled in this study. Serum and urinary klotho were determined using the ELISA technique in addition to other renal function tests.
Results: Serum and urinary alpha klotho were decreased in CKD patients when compared with control subjects. A positive correlation was found between serum creatinine and urinary alpha klotho in the patients' group.
Conclusion: Serum and urinary alpha klotho levels were decreased significantly in patients with chronic kidney disease compared with healthy controls.
Khodeir S, Okda H, Abdalal HM. Clinical significance of fibroblast growth factor-23 and soluble alpha klotho in different stages of chronic kidney disease. Saudi Journal of Kidney Diseases and Transplantation. 2019;30(1):108–118. Available from: https://dx.doi.org/10.4103/1319-2442.252900. DOI: https://doi.org/10.4103/1319-2442.252900
Perez-Gomez MV, Bartsch LA, Castillo-Rodriguez E, Fernandez-Prado R, Fernandez-Fernandez B, Martin-Cleary C, et al. Clarifying the concept of chronic kidney disease for non-nephrologists. Clinical Kidney Journal. 2019;12(2):258–261. Available from: https://dx.doi.org/10.1093/ckj/sfz007. DOI: https://doi.org/10.1093/ckj/sfz007
Garland JS. Elevated body mass index as a risk factor for chronic kidney disease: current perspectives. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2014;7:347–355. DOI: https://doi.org/10.2147/DMSO.S46674
Picciotto D, Murugavel A, Ansaldo F, Rosa GM, Sofia A, Milanesi S, et al. The Organ Handling of Soluble Klotho in Humans. Kidney and Blood Pressure Research. 2019;44(4):715–726. Available from: https://dx.doi.org/10.1159/000501316. DOI: https://doi.org/10.1159/000501316
Liu X, Niu Y, Zhang X, Zhang Y, Yu Y, Huang J, et al. Recombinant α-Klotho Protein Alleviated Acute Cardiorenal Injury in a Mouse Model of Lipopolysaccharide-Induced Septic Cardiorenal Syndrome Type 5. Analytical Cellular Pathology. 2019;2019. Available from: https://dx.doi.org/10.1155/2019/5853426. DOI: https://doi.org/10.1155/2019/5853426
Zhong X, Jagarlapudi S, Weng Y, Ly M, Rouse JC, McClure K, et al. Structurefunction relationships of the soluble form of the anti-aging protein Klotho have therapeutic implications for managing kidney disease. Journal of Biological Chemistry. 2020;295(10):3115–3133. Available from: https://dx.doi.org/10.1074/jbc.RA119.012144. DOI: https://doi.org/10.1074/jbc.RA119.012144
Kim JH, Hwang KH, Park KS, Kong ID, Cha SK. Biological role of anti-aging protein Klotho. Journal of Lifestyle Medicine . 2015;5(1):1–6. Available from: 10.15280/jlm.2015.5.1.1. DOI: https://doi.org/10.15280/jlm.2015.5.1.1
Sanchez-Niño MD, Fernandez-Fernandez B, Ortiz A. Klotho, the elusive kidneyderived anti-ageing factor . Clinical Kidney Journal. 2020;13(2):125–127. Available from: https://doi.org/10.1093/ckj/sfz125. DOI: https://doi.org/10.1093/ckj/sfz125
Liu QF, Yu LX, Feng JH, Sun Q, Li SS, Ye JM. The Prognostic Role of Klotho in Patients with Chronic Kidney Disease: A Systematic Review and Meta-analysis. Disease markers. 2019;2019(Article ID 6468729):1–12. Available from: https://doi.org/10.1155/2019/6468729. DOI: https://doi.org/10.1155/2019/6468729
Neyra JA, Hu MC. _Klotho and chronic kidney disease. In: Litwack G, et al., editors. Vitamins & Hormones . vol. 101. Academic Press; 2016. p. 257–310. Available from: https://doi.org/10.1016/bs.vh.2016.02.007. DOI: https://doi.org/10.1016/bs.vh.2016.02.007
Lu X, Hu MC. Klotho/FGF23 axis in chronic kidney disease and cardiovascular disease. Kidney Diseases. 2017;3(1):15–23. Available from: https://doi.org/10.1159/000452880. DOI: https://doi.org/10.1159/000452880
Seo MY, Yang J, Lee JY, Kim K, Kim SC, Chang H, et al. Renal Klotho expression in patients with acute kidney injury is associated with the severity of the injury. The Korean Journal of Internal Medicine. 2015;30(4):489. Available from: https://doi.org/10.3904/kjim.2015.30.4.489. DOI: https://doi.org/10.3904/kjim.2015.30.4.489
Lee EY, Kim SS, Lee JS, Kim IJ, Song SH, Cha SK, et al. Soluble α-klotho as a novel biomarker in the early stage of nephropathy in patients with type 2 diabetes. PLoS One. 2014;9(8):e102984. Available from: https://doi.org/10.1371/journal.pone.0102984. DOI: https://doi.org/10.1371/journal.pone.0102984
Tsai CW, Ting IW, Yeh HC, Kuo CC. Longitudinal change in estimated GFR among CKD patients: A 10-year follow-up study of an integrated kidney disease care program in Taiwan. PLoS One. 2017;12(4):e0173843. Available from: https://doi.org/10.1371/journal.pone.0173843. DOI: https://doi.org/10.1371/journal.pone.0173843
Melsom T, Nair V, Schei J, Mariani L, Stefansson VTN, Harder JL, et al. Correlation Between Baseline GFR and Subsequent Change in GFR in Norwegian Adults Without Diabetes and in Pima Indians. American Journal of Kidney Diseases. 2019;73(6):777–785. Available from: https://doi.org/10.1053/j.ajkd.2018.11.011. DOI: https://doi.org/10.1053/j.ajkd.2018.11.011
Kumaresan R, Giri P. A Comparison of Serum Cystatin C and Creatinine with Glomerular FiltrationRate in Indian Patients with Chronic Kidney Disease. Oman Medical Journal. 2011;26(6):421–425. Available from: https://dx.doi.org/10.5001/omj.2011.107. DOI: https://doi.org/10.5001/omj.2011.107
Al-Jewari, K., Baban, R., & Manuti, J. (2021). Serum and urinary soluble α-Klotho levels in patients with chronic kidney disease. Baghdad Journal of Biochemistry and Applied Biological Sciences, 2(01), 29–38. https://doi.org/10.47419/bjbabs.v2i01.35
Copyright (c) 2021 Khalid J. Al-Jewari, Rayah S. Baban, Jawad Kadhim Manuti
Zainab J. Subber, Ghassan A. Al-Shamma, Hashim M. Hashim, The total and free vitamin D in type 2 diabetes mellitus patients in Baghdad city , Baghdad Journal of Biochemistry and Applied Biological Sciences: Vol. 2 No. 02 (2021): April-June (2021)