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Serum Klotho in Living Kidney Donors and Kidney Transplant Recipients: A Meta-Analysis
α-Klotho is a known anti-aging protein that exerts diverse physiological effects, including phosphate homeostasis. Klotho expression occurs predominantly in the kidney and is significantly decreased in patients with chronic kidney disease. However, changes in serum klotho levels and impacts of kloth...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355868/ https://www.ncbi.nlm.nih.gov/pubmed/32545510 http://dx.doi.org/10.3390/jcm9061834 |
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author | Thongprayoon, Charat Neyra, Javier A. Hansrivijit, Panupong Medaura, Juan Leeaphorn, Napat Davis, Paul W. Kaewput, Wisit Bathini, Tarun Salim, Sohail Abdul Chewcharat, Api Aeddula, Narothama Reddy Vallabhajosyula, Saraschandra Mao, Michael A. Cheungpasitporn, Wisit |
author_facet | Thongprayoon, Charat Neyra, Javier A. Hansrivijit, Panupong Medaura, Juan Leeaphorn, Napat Davis, Paul W. Kaewput, Wisit Bathini, Tarun Salim, Sohail Abdul Chewcharat, Api Aeddula, Narothama Reddy Vallabhajosyula, Saraschandra Mao, Michael A. Cheungpasitporn, Wisit |
author_sort | Thongprayoon, Charat |
collection | PubMed |
description | α-Klotho is a known anti-aging protein that exerts diverse physiological effects, including phosphate homeostasis. Klotho expression occurs predominantly in the kidney and is significantly decreased in patients with chronic kidney disease. However, changes in serum klotho levels and impacts of klotho on outcomes among kidney transplant (KTx) recipients and kidney donors remain unclear. A literature search was conducted using MEDLINE, EMBASE, and Cochrane Database from inception through October 2019 to identify studies evaluating serum klotho levels and impacts of klotho on outcomes among KTx recipients and kidney donors. Study results were pooled and analyzed utilizing a random-effects model. Ten cohort studies with a total of 431 KTx recipients and 5 cohort studies with a total of 108 living kidney donors and were identified. After KTx, recipients had a significant increase in serum klotho levels (at 4 to 13 months post-KTx) with a mean difference (MD) of 243.11 pg/mL (three studies; 95% CI 67.41 to 418.81 pg/mL). Although KTx recipients had a lower serum klotho level with a MD of = −234.50 pg/mL (five studies; 95% CI −444.84 to −24.16 pg/mL) compared to healthy unmatched volunteers, one study demonstrated comparable klotho levels between KTx recipients and eGFR-matched controls. Among kidney donors, there was a significant decrease in serum klotho levels post-nephrectomy (day 3 to day 5) with a mean difference (MD) of −232.24 pg/mL (three studies; 95% CI –299.41 to −165.07 pg/mL). At one year following kidney donation, serum klotho levels remained lower than baseline before nephrectomy with a MD of = −110.80 pg/mL (two studies; 95% CI 166.35 to 55.24 pg/mL). Compared to healthy volunteers, living kidney donors had lower serum klotho levels with a MD of = −92.41 pg/mL (two studies; 95% CI −180.53 to −4.29 pg/mL). There is a significant reduction in serum klotho levels after living kidney donation and an increase in serum klotho levels after KTx. Future prospective studies are needed to assess the impact of changes in klotho on clinical outcomes in KTx recipients and living kidney donors. |
format | Online Article Text |
id | pubmed-7355868 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-73558682020-07-22 Serum Klotho in Living Kidney Donors and Kidney Transplant Recipients: A Meta-Analysis Thongprayoon, Charat Neyra, Javier A. Hansrivijit, Panupong Medaura, Juan Leeaphorn, Napat Davis, Paul W. Kaewput, Wisit Bathini, Tarun Salim, Sohail Abdul Chewcharat, Api Aeddula, Narothama Reddy Vallabhajosyula, Saraschandra Mao, Michael A. Cheungpasitporn, Wisit J Clin Med Article α-Klotho is a known anti-aging protein that exerts diverse physiological effects, including phosphate homeostasis. Klotho expression occurs predominantly in the kidney and is significantly decreased in patients with chronic kidney disease. However, changes in serum klotho levels and impacts of klotho on outcomes among kidney transplant (KTx) recipients and kidney donors remain unclear. A literature search was conducted using MEDLINE, EMBASE, and Cochrane Database from inception through October 2019 to identify studies evaluating serum klotho levels and impacts of klotho on outcomes among KTx recipients and kidney donors. Study results were pooled and analyzed utilizing a random-effects model. Ten cohort studies with a total of 431 KTx recipients and 5 cohort studies with a total of 108 living kidney donors and were identified. After KTx, recipients had a significant increase in serum klotho levels (at 4 to 13 months post-KTx) with a mean difference (MD) of 243.11 pg/mL (three studies; 95% CI 67.41 to 418.81 pg/mL). Although KTx recipients had a lower serum klotho level with a MD of = −234.50 pg/mL (five studies; 95% CI −444.84 to −24.16 pg/mL) compared to healthy unmatched volunteers, one study demonstrated comparable klotho levels between KTx recipients and eGFR-matched controls. Among kidney donors, there was a significant decrease in serum klotho levels post-nephrectomy (day 3 to day 5) with a mean difference (MD) of −232.24 pg/mL (three studies; 95% CI –299.41 to −165.07 pg/mL). At one year following kidney donation, serum klotho levels remained lower than baseline before nephrectomy with a MD of = −110.80 pg/mL (two studies; 95% CI 166.35 to 55.24 pg/mL). Compared to healthy volunteers, living kidney donors had lower serum klotho levels with a MD of = −92.41 pg/mL (two studies; 95% CI −180.53 to −4.29 pg/mL). There is a significant reduction in serum klotho levels after living kidney donation and an increase in serum klotho levels after KTx. Future prospective studies are needed to assess the impact of changes in klotho on clinical outcomes in KTx recipients and living kidney donors. MDPI 2020-06-12 /pmc/articles/PMC7355868/ /pubmed/32545510 http://dx.doi.org/10.3390/jcm9061834 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Thongprayoon, Charat Neyra, Javier A. Hansrivijit, Panupong Medaura, Juan Leeaphorn, Napat Davis, Paul W. Kaewput, Wisit Bathini, Tarun Salim, Sohail Abdul Chewcharat, Api Aeddula, Narothama Reddy Vallabhajosyula, Saraschandra Mao, Michael A. Cheungpasitporn, Wisit Serum Klotho in Living Kidney Donors and Kidney Transplant Recipients: A Meta-Analysis |
title | Serum Klotho in Living Kidney Donors and Kidney Transplant Recipients: A Meta-Analysis |
title_full | Serum Klotho in Living Kidney Donors and Kidney Transplant Recipients: A Meta-Analysis |
title_fullStr | Serum Klotho in Living Kidney Donors and Kidney Transplant Recipients: A Meta-Analysis |
title_full_unstemmed | Serum Klotho in Living Kidney Donors and Kidney Transplant Recipients: A Meta-Analysis |
title_short | Serum Klotho in Living Kidney Donors and Kidney Transplant Recipients: A Meta-Analysis |
title_sort | serum klotho in living kidney donors and kidney transplant recipients: a meta-analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355868/ https://www.ncbi.nlm.nih.gov/pubmed/32545510 http://dx.doi.org/10.3390/jcm9061834 |
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