Serum Klotho Protein Level And Vascular Calcification In Maintenance Hemodialysis Patients

Backkground:Vascular calcification is a common complication in maintenance hemodialysis patients,and it can increase cardiovascular events in MHD patients.In addition,vascular calcification is the independent risk factors of death in end-stage kidney disease patients.At present,the mechanism of vascular calcification is complex and is unsolved.Tthere are no good method to treat vascular calcification.The increasing of blood phosphorus levels are closely associated with vascular calcification.Klotho is a anti-aging proteins mainly existed in the kidney,and it can regulating calcium phosphorus absorption together with fibroblast growth factor-23(FGF-23)to influence vascular calcification.Objective: To investigate the correlation between serum Klotho protein level and vascular calcification in maintenance hemodialysis patients.Methods: A total 143 maintenance hemodialysis patients with treatmen above 6months from our hosipital were selected during March 2015 to March 2017.We collected their clinical characters,such as their gender,age of dialysis,serum calcium,phosphorus,serum albumin,hemoglobin,serum i PTH,25(OH)2 vd3,and so on.The scores of vascular calcification degree in MHD patients was evaluated by X-ray detection,according to scores,they were devided to four groups,no calcification group,slight calcification group,medium group and severe calcification group,respectively.Serum Klotho protein and FGF-23 level from patients blood before hemodialysis were detected by enzyme linked immunosorbent assay(ELISA)according to the instruction manual.Analysing of vascular calcification in patients with MHD,we compared clinical characters and serum FGF-23 and Klotho level in different vascular calcification groups of patients,and analyzes the factors of vascular calcification in MHD patients.Results: This study showed there are 78 male and 65 female with average57.14±12.58 years old.There are 35 patients(account for 24.5%)no with vascular calcification and 108 patients(account for 75.5%)with vascular calcification in 143 patients.Among 143 patients,there are 41 patients in slight calcification group,36 patients in medium group and 31 patients in severe calcification group.The serum Klotho protein(P<0.05),FGF-23(P<0.05),serum calcium(P<0.05),serum phosphatase(P<0.05)and i PTH(P<0.05)level were statistically different among patients with different degrees of vascular calcification.However,age,dialysis patient age,serum albumin,hemoglobin level have no difference statistically in different degree calcification group.Spearman correlation analysis results showed that serum calcium(r=0.352,P<0.05),serum phosphorus(r=0.456,P<0.05),i PTH(r=0.384,P<0.05),FGF-23(r=0.332,P<0.05)levels were positively correlated with vascular calcification,and serum Klotho(r=-0.462,P<0.05))level was negatively correlated with vascular calcification.The Logistic regression analysis showed that in MHD patients serum Klotho decline wsa an independent risk factor of vascular calcification.Conclusion: Vascular calcification is common in MHD patients,and the serum Klotho protein level was negatively correlated with the degree of vascular calcification.In addition,serum Klotho decline was an independent risk factor of vascular calcification(β=-0.005,P<0.05).