Abstract
RENAL PROTECTIVE EFFECT OF s-KLOTHO IN TYPE 2 DIABETIC PATIENTS WITH CHRONIC KIDNEY DISEASES

Dina M. Seoudi*, Germine M. Hamdy and Samah Bastawy

ABSTRACT

anti-aging, anti-oxidant and biological modulatory agent, has been proved recently to be involved in the mechanism underlying the diabetic kidney injury. However, its precise role as well as its association with the chronic kidney diseases (CKD) progression have not been yet established. Therefore, this study aims to evaluate the variations of serum secreted Klotho (s-Klotho) levels, with different CKD stages as determined by urinary albumin excretion rate (UAER) in type II diabetic patients (T2DM). A total of 75 T2DM patients with mild to moderate CKD were enrolled in this study, from the nephrology unit at Badr hospital, faculty of Medicine-Helwan university, between January and June 2017, as well as 15 control subjects. Patients were divided according to their UAER into three groups (25 patients each) as follow: normotensive early diabetic nephropathy (Early-DN) patients with normoalbuminuria; hypertensive DN patients with microalbuminuria; hypertensive DN patients with macroalbuminuria, and receiving hemodialysis (HD) 2-3 times/week. The concentration of serum s-Klotho, and urinary microalbumin were measured by enzyme-linked immunosorbent assay (ELISA) in all groups. HbA1c%, urea, creatinine, calcium and phosphates were also investigated. Elevations in s-Klotho level was greater in DN group (P0.001) than HD group (P 0.05) compared to control subjects, while no observed increase was observed in early-DN group. In conclusion, the results of the present study suggest that the elevated s-Klotho levels observed in patients with well-established DN and decreased with increasing UAER may at least in part contribute to the cardiorenal protective effects of active vitamin-D by upregulating Klotho levels in those patients. Therefore, correction of Klotho deficiency may be a therapeutic approach for treatment of CKD.
KEYWORDS: s-Klotho, diabetic nephropathy, urinary

Keywords: excretion rate, chronic kidney disease. *Corresponding Author: Dina M. Seoudi


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