Golembiewska Edyta, Safranow Krzysztof, Kabat-Koperska Joanna, Myślak Marek, Ciechanowski Kazimierz
Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.
Acta Biochim Pol. 2013;60(2):191-4. Epub 2013 Jun 7.
Active vitamin D (1,25-dihydroxyvitamin D₃), PTH, fibroblast growth factor-23 (FGF-23) and Klotho protein are key regulators of phosphate metabolism. Hyperphosphatemia and increased FGF-23 level in patients with end-stage renal disease are associated with increased morbidity and mortality. The relationships among key regulators of phosphate metabolism are still being investigated. FGF-23, the humoral factor involved in phosphate metabolism, is strongly associated with serum phosphorus level. Klotho, a transmembrane protein expressed primarily in renal tubules, functions as an obligatory co-receptor for FGF-23. The soluble form of Klotho, produced by the shedding of the transmembrane protein, is detectable in body fluids. The purpose of the study was to assess if serum soluble alpha-Klotho level was related to phosphate metabolism parameters and residual renal function (RRF) in incident peritoneal dialysis (PD) patients.
Thirty-five clinically stable patients 4 to 6 weeks after the onset of PD were included in the study. For each patient, clinical and laboratory data were reviewed. Serum phosphorus concentration, urinary and peritoneal phosphate clearance, serum FGF-23 and soluble Klotho protein concentrations were determined.
Serum soluble alpha-Klotho was strongly negatively correlated with 24-hour diuresis (Rs = -0.55, p = 0.004) and renal phosphate clearance (Rs = -0.40, p = 0.049), but not with RRF.
Serum soluble Klotho protein concentration is inversely related to residual diuresis and renal phosphate clearance in incident PD patients.
活性维生素D（1,25 - 二羟维生素D₃）、甲状旁腺激素（PTH）、成纤维细胞生长因子23（FGF - 23）和Klotho蛋白是磷代谢的关键调节因子。终末期肾病患者的高磷血症和FGF - 23水平升高与发病率和死亡率增加相关。磷代谢关键调节因子之间的关系仍在研究中。FGF - 23是参与磷代谢的体液因子，与血清磷水平密切相关。Klotho是一种主要在肾小管表达的跨膜蛋白，作为FGF - 23的必需共受体发挥作用。跨膜蛋白脱落产生的可溶性Klotho形式可在体液中检测到。本研究的目的是评估初发腹膜透析（PD）患者的血清可溶性α - Klotho水平是否与磷代谢参数及残余肾功能（RRF）相关。
本研究纳入了35例PD开始后4至6周临床稳定的患者。对每位患者的临床和实验室数据进行回顾。测定血清磷浓度、尿磷和腹膜磷清除率、血清FGF - 23和可溶性Klotho蛋白浓度。
血清可溶性α - Klotho与24小时尿量（Rs = - 0.55，p = 0.004）和肾脏磷清除率（Rs = - 0.40，p = 0.049）呈强烈负相关，但与RRF无关。
初发PD患者的血清可溶性Klotho蛋白浓度与残余尿量和肾脏磷清除率呈负相关。
