Liu Qi-Feng, Sun Zhuo-Yi, Tang Xiao-Fang, Yu Li-Xia, Li Sha-Sha
Department of Nephrology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, Jiangsu, China.
Department of Education, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, Jiangsu, China.
Ther Adv Chronic Dis. 2025 Feb 14;16:20406223251318481. doi: 10.1177/20406223251318481. eCollection 2025.
Klotho is a kidney-derived protein that is involved in various kidney diseases. The role of serum soluble Klotho (sKlotho) in the anemia of patients undergoing hemodialysis has not been well characterized.
We aimed to characterize the relationship between sKlotho and hemoglobin (Hb) levels in this group of patients.
A single-center cross-sectional study of 208 patients undergoing maintenance hemodialysis (MHD) and 50 healthy controls was performed between June 1 and 31, 2023.
Demographic information and biomedical parameters, such as age, body mass index, medication use, and their Hb, albumin, interleukin-6, and sKlotho concentrations, were obtained. Patients undergoing MHD were allocated to a group that achieved the Hb target (⩾110 g/L) and a group that did not (<110 g/L). Correlation analysis and multivariate logistic and linear regression analyses were performed to evaluate the relationship of sKlotho with Hb concentration.
Participants undergoing MHD had lower Hb and sKlotho concentrations than controls. Those who had not achieved the target Hb level were given fewer erythropoiesis-stimulating agents and had lower sKlotho and albumin concentrations, but higher interleukin-6 concentrations, than those who had achieved the Hb target. The sKlotho concentration positively correlated with the Hb concentration and was inversely associated with the incidence of a lack of achievement of the target Hb level. Multivariate logistic regression models revealed that there was a close association between sKlotho and a lack of achievement of the target Hb level after adjustment for potential confounders (odds ratio: 0.335, 95% confidence interval: 0.142-0.791, = 0.013). This relationship was closer on multivariate linear regression analysis when sKlotho was included as a continuous variable.
The circulating sKlotho concentration is very low, but deficiency of this protein is independently associated with a high risk of anemia in patients undergoing MHD. Therefore, the routine monitoring of sKlotho concentration might be useful in the management of renal anemia in such patients.
Klotho是一种源自肾脏的蛋白质，参与多种肾脏疾病。血清可溶性Klotho（sKlotho）在接受血液透析患者贫血中的作用尚未得到充分阐明。
我们旨在明确该组患者中sKlotho与血红蛋白（Hb）水平之间的关系。
于2023年6月1日至31日对208例接受维持性血液透析（MHD）的患者和50例健康对照进行了单中心横断面研究。
获取人口统计学信息和生物医学参数，如年龄、体重指数、用药情况以及他们的Hb、白蛋白、白细胞介素-6和sKlotho浓度。接受MHD的患者被分为达到Hb目标（⩾110 g/L）的组和未达到目标（<110 g/L）的组。进行相关性分析以及多因素逻辑回归和线性回归分析，以评估sKlotho与Hb浓度之间的关系。
接受MHD的参与者的Hb和sKlotho浓度低于对照组。未达到目标Hb水平的患者接受促红细胞生成剂治疗的次数较少，且sKlotho和白蛋白浓度较低，但白细胞介素-6浓度高于达到Hb目标的患者。sKlotho浓度与Hb浓度呈正相关，与未达到目标Hb水平的发生率呈负相关。多因素逻辑回归模型显示，在对潜在混杂因素进行调整后，sKlotho与未达到目标Hb水平之间存在密切关联（比值比：0.335，95%置信区间：0.142 - 0.791，P = 0.013）。当将sKlotho作为连续变量纳入多因素线性回归分析时，这种关系更为密切。
循环sKlotho浓度非常低，但这种蛋白质的缺乏与接受MHD患者的高贫血风险独立相关。因此，常规监测sKlotho浓度可能有助于此类患者肾性贫血的管理。
