Peng Pei-Shan, Lu Wei
Department of Nephrology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, No. 1665 Kongjiang Road, Shanghai, China.
Int Urol Nephrol. 2025 Apr 1. doi: 10.1007/s11255-025-04475-5.
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.
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.
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.
Serum Klotho and FGF-23 levels are potential predictors of VC severity in patients with non-dialysis CKD.
在慢性肾脏病（CKD）患者中，血管钙化（VC）很常见，且会影响患者的结局和预后。然而，VC严重程度的评估方法有限。Klotho和成纤维细胞生长因子23（FGF - 23）是与VC发生相关的生物标志物。本研究旨在探讨非透析CKD患者血清Klotho和FGF - 23水平与VC严重程度之间的关联。
非透析CKD患者在住院期间入组，并根据其冠状动脉钙化（CAC）评分分为以下四组：无VC（CAC评分 = 0）、轻度VC（0 < CAC评分≤100）、中度VC（100 < CAC评分≤400）和重度VC组（CAC评分> 400）。比较不同组间血清Klotho和FGF - 23水平。
共纳入154例非透析CKD患者。相关性分析显示，CKD患者血清FGF - 23水平（rho = 0.185，p = 0.022）与VC严重程度呈正相关，而血清Klotho水平（rho = - 0.196，p = 0.015）与VC严重程度呈负相关。多变量回归分析显示，Klotho水平[比值比（OR）= 0.998，95%置信区间（CI）0.996 - 0.999，p = 0.001]是CKD患者VC严重程度的保护因素，而FGF - 23水平（OR = 1.005，95% CI 1.001 - 1.009，p = 0.020）被确定为VC严重程度的危险因素。
血清Klotho和FGF - 23水平是非透析CKD患者VC严重程度的潜在预测指标。
