Javier A Neyra
University of Texas Southwestern School of Medicine, USA
Posters & Accepted Abstracts: J Nephrol Ther
AKI is associated with increased mortality and carries increased risk for subsequent CKD. Klotho deficiency has been observed in experimental AKI and low Klotho post-AKI is associated with progression to CKD in rodents. We conducted a prospective study of 29 AKI patients and 29 controls without AKI in the ICU setting. We excluded patients with baseline eGFR<60 or kidney transplant. Urine samples were obtained within 24 hours of peak serum creatinine (SCr) or at RRT initiation in AKI cases and within 24 hours of ICU admission in frequency-matched controls (by baseline eGFR and age). AKI was defined by KDIGO stage �2 criteria. Longitudinal data from AKI cases were obtained throughout hospital stay. Renal recovery was defined as the ratio of follow-up SCr/ baseline SCr�1.5. Urine Klotho was measured by immunoprecipitation-immunoblot. Mean (SD) age was 58 (17) years, 62% were men and 75% white. Five (17.2%) patients died and 8 (27.6%) required RRT in the AKI group. Only 3.5% patients died in the control group. Urine Klotho adjusted by urine creatinine (uKlotho/Cr) was significantly lower in AKI cases than in controls, median 10 [IQR 4-20] vs. 28 [14-52] fmol/mg, p=0.003. Furthermore, uKlotho/Cr significantly increased with time in patients that exhibited renal recovery (n=7, ��+216%, p=0.05) but not in those that did not (n=7, ��+8%, p=0.91), mean follow-up 8 days. UKlotho/Cr is significantly lower in patients with AKI when compared to ICU controls without AKI. uKlotho/Cr recovered only in patients that recovered kidney function. Klotho may serve as a prognostic marker for AKI recovery.
Journal of Nephrology & Therapeutics received 784 citations as per Google Scholar report
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