Association of serum Klotho and fibroblast growth factor-23 levels with vascular calcification severity in patients with chronic kidney disease: an observational cohort study.

PURPOSE

In patients with chronic kidney disease (CKD), vascular calcification (VC) is common and influences patient's outcome and prognosis. However, evaluation methods for VC severity are limited. Klotho and fibroblast growth factor-23 (FGF-23) are biomarkers associating with VC development. This study aimed to explore the association of serum Klotho and FGF-23 levels with VC severity in patients with non-dialysis CKD.

METHODS

Patients with non-dialysis CKD were enrolled during hospitalization and were divided into the following four groups on the basis of their coronary artery calcification (CAC) scores: non-VC (CAC scores = 0), mild VC (0 < CAC scores ≤ 100), moderate VC (100 < CAC scores ≤ 400), and severe VC groups (CAC scores > 400). Serum Klotho and FGF-23 levels among the different groups were compared.

RESULTS

A total of 154 non-dialysis CKD patients were enrolled. Correlation analysis showed that serum FGF-23 level (rho = 0.185, p = 0.022) was positively correlated with VC severity, whereas serum Klotho level (rho =  -  0.196, p = 0.015) was negatively correlated with VC severity in patients with CKD. Multivariable regression analysis showed that Klotho level [odd ratio (OR) = 0.998, 95% confidence interval (CI) 0.996-0.999, p = 0.001] served as a protective factor for VC severity in patients with CKD, whereas FGF-23 level (OR = 1.005, 95% CI 1.001-1.009, p = 0.020) was identified as risk factor for VC severity.

CONCLUSION

Serum Klotho and FGF-23 levels are potential predictors of VC severity in patients with non-dialysis CKD.