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05 November 2018 : Clinical Research  

The Value of Older Donors’ Klotho Level in Predicting Recipients’ Short-Term Renal Function

Gengguo Deng1ACE, Anli Yang2AE, Jiaqing Wu1BC, Jiexue Zhou1DF, Shandong Meng1BCE, Chunli Zhu1ADF, Jianfu Wang1CF, Sheng Shen1EF, Juan Ma1FG, Dong Liu1AEG*

DOI: 10.12659/MSM.913274

Med Sci Monit 2018; 24: CLR7936-7943

Abstract

BACKGROUND: The present organ shortage has led to increased use of kidneys from expanded-criteria donors, but the prognosis is disappointing due to poor graft quality. As a promising kidney protector, the Klotho gene’s role in predicting short-term prognosis has not been assessed.

MATERIAL AND METHODS: We retrospectively analyzed data from 41 recipients and 25 donors. Multiple clinical variables were compared between different subgroups of donors or their corresponding recipients. The area under the receiver operating characteristic curve (AUROC) was used to evaluate the distinguishing ability. Dynamic changes in serum Klotho, FGF-23, and urinary NGAL were assessed.

RESULTS: Serum Klotho level was significantly lower in donors age ≥50 years (p=0.017), and there was a moderate negative correlation between serum Klotho expression and age (r=–0.464, p=0.019). Moreover, detection of Klotho mRNA and immunohistochemical analysis in kidneys revealed the same trend as in serum. Furthermore, for older donors (age ≥50 years), serum Klotho level had a strong negative correlation with recipient eGFR 1 month post-transplant (r=–0.686, p=0.007), which was proved to be a good predictor for estimating graft function by ROC analysis. Additionally, during the post-transplant follow-up, serum Klotho levels increased slightly after a temporary decline, while serum FGF-23 and urinary NGAL decreased significantly and then stayed low thereafter.

CONCLUSIONS: Klotho level, which decreases with age, may be a potential predictor of short-term renal function, especially for grafts from older donors.

Keywords: Aging, Biological Markers, Kidney Transplantation, Tissue Donors

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750