Urinary Klotho Excretion: A Key Regulator of Sodium Homeostasis in Chronic Kidney Disease Stage 2-4

IF 1.5 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Po-Jui Chi, Chung-Jen Lee, Shih-Yuan Hung, Jen-Pi Tsai, Hung-Hsiang Liou
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Abstract

BACKGROUND:Soluble alpha-klotho (klotho) is considered an important regulator of mineral homeostasis in patients with chronic kidney disease (CKD). Since the mineral transport proteins are located on the apical membrane of renal tubular cells, we hypothesized that urine klotho may also be involved in their homeostasis. We aimed to investigate the associations between serum and urine klotho and their impacts on mineral homeostasis in patients with stage 2 to 4 CKD. MATERIAL AND METHODS:Serum, spot urine, and 24-h urine of klotho were measured by using enzyme-linked immunosorbent assay. Fractional excretion of sodium, potassium, calcium, phosphate, magnesium, and klotho were calculated. RESULTS:A total of 53 patients with CKD stages 2 to 4 were enrolled in this cross-sectional study. The mean age was 71.1±10.5 years, and 68% were men. Linear regression analysis showed that serum log-transformed klotho was negatively associated with log-transformed fractional excretion of klotho (log-FEKlotho) (ß=-0.085, P=0.02), showing that urinary klotho excretion could negatively regulate serum klotho levels. Moreover, our multivariate stepwise regression showed log-fractional excretion of sodium was positively associated with log-FEKlotho (ß=0.138, P=0.032). This implied urinary klotho excretion positively regulated urinary sodium excretion. CONCLUSIONS:Our study showed that urine klotho excretion resulted in decreased serum klotho levels and enhanced urinary sodium excretion in patients with CKD stages 2 to 4. In addition to serum klotho, we found, for the first time, that urine klotho also played a significant role in sodium homeostasis.
尿克洛索排泄:慢性肾病2-4期钠稳态的关键调节因子
背景:可溶性α -klotho (klotho)被认为是慢性肾脏疾病(CKD)患者体内矿物质平衡的重要调节因子。由于矿物质运输蛋白位于肾小管细胞的顶膜上,我们假设尿氯也可能参与了肾小管细胞的内稳态。我们的目的是研究2 - 4期CKD患者血清和尿液klotho之间的关系及其对矿物质稳态的影响。材料与方法:采用酶联免疫吸附法测定klotho的血清、斑点尿和24小时尿。计算钠、钾、钙、磷酸盐、镁和氯梭素的排泄分数。结果:共有53名CKD 2 - 4期患者被纳入这项横断面研究。平均年龄71.1±10.5岁,男性占68%。线性回归分析显示,血清log-转化klotho与log-转化klotho分数排泄(log-FEKlotho)呈负相关(ß=-0.085, P=0.02),表明尿klotho排泄可负向调节血清klotho水平。此外,我们的多元逐步回归显示,钠排泄量的对数分数与log-FEKlotho呈正相关(ß=0.138, P=0.032)。这暗示尿氯索排泄积极调节尿钠排泄。结论:我们的研究表明,尿klotho排泄导致CKD 2 - 4期患者血清klotho水平降低,尿钠排泄增加。除了血清klotho外,我们首次发现尿klotho在钠稳态中也起着重要作用。
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来源期刊
Medical Science Monitor Basic Research
Medical Science Monitor Basic Research MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
6.00
自引率
0.00%
发文量
16
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