Fibroblast growth factor-23 (FGF-23) / soluble Klotho protein (sKlotho) / sclerostin glycoprotein ratio disturbance is a novel risk factor for cardiovascular complications in ESRD patients receiving treatment with regular hemodialysis or hemodiafiltration

Milоvаnоvа, Ludmilа; Юрьевна, Милованова Людмила; Dobrosmyslov, I A; Александрович, Добросмыслов Игорь; Milovanov, Yuriy; Сергеевич, Милованов Юрий; Фомин, В В; Викторович, Фомин Виктор; Taranova, Marina; Владимировна, Таранова Марина; Kozlov, Vasiliy; Владимирович, Козлов Василий; Milоvаnova, Svetlana; Юрьевна, Милованова Светлана; Kozevnikova, Elena; Ивановна, Кожевникова Елена

doi:10.26442/terarkh201890648-54

Cited by 14 publications

(14 citation statements)

References 21 publications

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“…CIMT and AAC grade were used in this study to judge the development of cardiovascular thickening and calcification. The results observed the rising of both CIMT and AAC grades in patients with a lower level of klotho, which were like previous studies (13,15,(23)(24)(25). The mechanism of how decreased serum soluble klotho level leads to cardiovascular thickening and calcification is not clear to date.…”

Section: Discussionsupporting

confidence: 85%

Tanshinone IIA elevates serum soluble klotho levels and decreases cardiovascular events in patients on maintenance hemodialysis: a prospective before-after study

Zhang

et al. 2020

Ann Palliat Med

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Background: Cardiovascular disease (CVD) is the most common adverse event of maintenance hemodialysis (MHD), in which serum soluble klotho plays a vital role. Tanshinone IIA (tan) has been used to protect the cardiovascular system for hundreds of years. This study was performed to investigate the effects of tan on klotho level and cardiovascular events of MHD patients.Methods: Totally 112 patients were enrolled in this study, and their demographic, clinical, and laboratory characteristics were collected at admission. Serum soluble klotho, carotid intima-media thickness (CIMT), and abdominal aorta calcification (AAC) level were measured to determine their relationship. Seventy-one patients were given sodium tan sulfonate injection according to their willingness, while 41 patients were not given any specific treatment. The endpoint events were recorded, including cardiovascular mortality, nonfatal cardiovascular events, and all-cause mortality.Results: All patients were divided into two groups on whether the level of serum soluble klotho was more than medium or not. CIMT and AAC grade showed significant differences between 2 groups (group of low level of klotho versus group of high level of klotho, CIMT: 1.03±0.22 vs. 0.85±0.20 mm, P<0.001; AAC grade: 5.04±3.93 vs. 1.69±2.30 points, P<0.001). All patients were followed up for at least one year.The results revealed that using tan improved the level of serum soluble klotho (490.23±153.97 pg/mL after using tan versus 444.49±143.32 pg/mL before using tan, P=0.042). Kaplan-Meier curves showed that cardiovascular event-free survival was significantly higher in patients given tan (P=0.040) compared with patients not given tan.Conclusions: Tan effectively increases the level of serum soluble klotho and further reduces the incidence of cardiovascular events in MHD patients.

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Section: Discussionsupporting

confidence: 85%

Tanshinone IIA elevates serum soluble klotho levels and decreases cardiovascular events in patients on maintenance hemodialysis: a prospective before-after study

Zhang

et al. 2020

Ann Palliat Med

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“…A number of researches demonstrated that FGF23 can regulate a variety of signaling pathways in human body, such as mineral metabolism, insulin resistance, energy balance, premature aging, etc. (Lacroix & Urena-Torres, 2020;Milovanova et al, 2018). Combination of Klotho with fibroblast growth factor receptor 1 (FGFR1) can form a transmembrane co-receptor of FGF23 to regulate FGF23/FGFR1/Klotho signal transduction.…”

Section: Discussionmentioning

confidence: 99%

The correlation between fibroblast growth factor-23 and ESRD patients with hearing impairment

Nie

Guo

et al. 2021

PeerJ

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Background End-stage renal disease (ESRD) patients often experience hearing impairment, resulting in a high rate of disability and a decline in their quality of life. Fibroblast growth factor-23 (FGF23) is a diagnostic biomarker for chronic kidney disease (CKD) and a pathogenic contributor to CKD progression. However, the correlation between FGF23 level and CKD patients with hearing impairment remains elusive. This study aimed to investigate the relationship between the FGF23 and ESRD accompanied with hearing impairment. Methods A total of 144 ESRD patients, who were admitted to the First Affiliated Hospital of Kunming Medical University from November to December 2020, were enrolled in this study. Firstly, 144 ESRD patients underwent pure-tone audiometry (PTA). Secondly, it was attempted to randomly select 20 ESRD patients with normal hearing, and 20 ESRD patients with hearing impairment (match ratio, 1:1). Age- and gender-matched healthy people (n = 20) were also recruited as controls group. The expression levels of FGF23 was detected by enzyme-linked immunosorbent assay (ELISA). Results The results of pure-tone audiometry showed that the prevalence of hearing impairment in ESRD patients was 80.5%. Male ESRD patients were more likely to develop hearing impairment compared to female patients. The incidence rate of hearing impairment at a high frequency was significantly higher than that at a low frequency (P < 0.01). The serum levels of FGF23, phosphorus, and parathyroid hormone (PTH) in ESRD patients with hearing impairment significantly increased compared with those with normal hearing and healthy controls. Conclusion ESRD patients had a higher risk of hearing loss, especially high-frequency hearing impairment. As FGF23 level increased, the risk of hearing loss was also elevated. The hearing impairment in ESRD patients was associated with the degree of kidney injury, and serum FGF23 level.

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“…In turn, other authors showed that increased levels of ox-LDL induce a decrease in renal expression of klotho [235]. A recent study conducted in patients treated by HD showed that higher serum FGF-23 levels and lower levels of sKL and sclerostin (endogenous Wnt inhibitor) were associated with chronic inflammation, malnutrition, and secondary hyperparathyroidism, and they may be considered as prognostic factors for CVD and its complications, such as left ventricular hypertrophy, acute coronary syndrome, or cardiac arrhythmias [236]. On the other hand, data on the relationship between klotho and kidney function are divergent.…”

Section: Klotho Proteinmentioning

confidence: 99%

Chronic Kidney Disease as Oxidative Stress- and Inflammatory-Mediated Cardiovascular Disease

Podkowińska¹,

2020

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Generating reactive oxygen species (ROS) is necessary for both physiology and pathology. An imbalance between endogenous oxidants and antioxidants causes oxidative stress, contributing to vascular dysfunction. The ROS-induced activation of transcription factors and proinflammatory genes increases inflammation. This phenomenon is of crucial importance in patients with chronic kidney disease (CKD), because atherosclerosis is one of the critical factors of their cardiovascular disease (CVD) and increased mortality. The effect of ROS disrupts the excretory function of each section of the nephron. It prevents the maintenance of intra-systemic homeostasis and leads to the accumulation of metabolic products. Renal regulatory mechanisms, such as tubular glomerular feedback, myogenic reflex in the supplying arteriole, and the renin–angiotensin–aldosterone system, are also affected. It makes it impossible for the kidney to compensate for water–electrolyte and acid–base disturbances, which progress further in the mechanism of positive feedback, leading to a further intensification of oxidative stress. As a result, the progression of CKD is observed, with a spectrum of complications such as malnutrition, calcium phosphate abnormalities, atherosclerosis, and anemia. This review aimed to show the role of oxidative stress and inflammation in renal impairment, with a particular emphasis on its influence on the most common disturbances that accompany CKD.

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Fibroblast growth factor-23 (FGF-23) / soluble Klotho protein (sKlotho) / sclerostin glycoprotein ratio disturbance is a novel risk factor for cardiovascular complications in ESRD patients receiving treatment with regular hemodialysis or hemodiafiltration

Cited by 14 publications

References 21 publications

Tanshinone IIA elevates serum soluble klotho levels and decreases cardiovascular events in patients on maintenance hemodialysis: a prospective before-after study

Tanshinone IIA elevates serum soluble klotho levels and decreases cardiovascular events in patients on maintenance hemodialysis: a prospective before-after study

The correlation between fibroblast growth factor-23 and ESRD patients with hearing impairment

Chronic Kidney Disease as Oxidative Stress- and Inflammatory-Mediated Cardiovascular Disease

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