Aim The potential role of soluble α-klotho in diabetic kidney disease has not yet been evaluated. The aim of this study was to evaluate the association of plasma and/or urine α-klotho with the progression of type 2 diabetic nephropathy. Methods The baseline values of plasma and urine α-klotho were measured in 147 patients with type 2 diabetes mellitus with an estimated glomerular filtration rate (eGFR) of ≥ 60 mL/min/1.73 m2. In this prospective observational study, a total of 109 type 2 diabetic patients were followed up for 34 months (8-50 months). Results Plasma α-klotho, but not urine α-klotho, was negatively correlated with the decline of eGFR (r = - 0.304, P = 0.001; r = 0.042, P = 0.068, respectively). After adjusting for several clinical parameters, baseline eGFR and urine ACR, plasma α-klotho was significantly associated with the decline of eGFR (r = - 0.219, P = 0.008). In the normoalbuminuria group (n = 63), the plasma α-klotho remained significantly associated with a decline in eGFR (r = 0.324, P = 0.004) in the final model. Conclusions It is suggested that plasma α-klotho may be an early biomarker for predicting renal impairment in type 2 diabetic patients. The disappearance of a compensatory increase of plasma α-klotho might be a predictive marker for the progression of type 2 diabetic nephropathy.
Bibliographical noteFunding Information:
Funding: This research was supported by a Biomedical Research Institute grant (2014–1) from Pusan National University Hospital and the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2012R1A1A2044121).
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All Science Journal Classification (ASJC) codes
- Internal Medicine
- Endocrinology, Diabetes and Metabolism