Department of Nephrology, Affiliated Kunshan Hospital of Jiangsu University, 91 Qianjin West Road, Kunshan, Jiangsu 215300, China.
Clinical Research & Lab Centre, Affiliated Kunshan Hospital of Jiangsu University, 91 Qianjin West Road, Kunshan, Jiangsu 215300, China.
Dis Markers. 2020 Nov 12;2020:4923970. doi: 10.1155/2020/4923970. eCollection 2020.
The predictive value of soluble Klotho (sKlotho) for adverse outcomes in patients on maintenance hemodialysis (MHD) is controversial. In this study, we aimed to clarify the potential association of sKlotho levels with adverse outcomes in this patient population.
A total of 211 patients on MHD were identified and stratified according to the median sKlotho level. Patients were followed up for adverse outcomes including cardiovascular (CV) morbidity and all-cause mortality.
During the 36-month follow-up, 75 patients [51 CV events (including 16 CV deaths) and 40 deaths] experienced adverse outcomes. After stratification according to median sKlotho level, patients with a lower sKlotho level had a greater risk of CV events (38.2% vs. 19.5%, = 0.006), all-cause mortality (28.4% vs. 11.6%, = 0.003), and combined adverse outcomes (51.0% vs. 24.2%, < 0.001). Similar observations were made from analyses using Kaplan-Meier survival curves. Cox regression analysis showed that a low sKlotho level was strongly correlated with CV morbidity [1.942 (1.030-3.661), = 0.040)], all-cause mortality [2.073 (1.023-4.203), = 0.043], and combined adverse outcomes [1.818 (1.092-3.026), = 0.021] in fully adjusted models.
The sKlotho level was an independent predictive factor of adverse outcomes including CV morbidity and mortality in patients on MHD.
可溶性 Klotho（sKlotho）对维持性血液透析（MHD）患者不良结局的预测价值存在争议。本研究旨在明确 sKlotho 水平与该患者人群不良结局的潜在关联。
共纳入 211 名 MHD 患者，根据 sKlotho 中位数水平进行分层。对患者进行不良结局（包括心血管（CV）发病率和全因死亡率）随访。
在 36 个月的随访期间，75 名患者（51 例 CV 事件（包括 16 例 CV 死亡）和 40 例死亡）发生不良结局。根据 sKlotho 中位数水平分层后，sKlotho 水平较低的患者 CV 事件（38.2%比 19.5%， = 0.006）、全因死亡率（28.4%比 11.6%， = 0.003）和复合不良结局（51.0%比 24.2%， < 0.001）的风险更高。使用 Kaplan-Meier 生存曲线进行的分析也得到了类似的观察结果。Cox 回归分析表明，低 sKlotho 水平与 CV 发病率（1.942（1.030-3.661）， = 0.040）、全因死亡率（2.073（1.023-4.203）， = 0.043）和复合不良结局（1.818（1.092-3.026）， = 0.021）在完全调整模型中均呈显著相关。
sKlotho 水平是 MHD 患者不良结局（包括 CV 发病率和死亡率）的独立预测因素。
