Time dependent changes of klotho and FGF-23 levels after kidney transplantation: role of cold ischemia time, renal function and graft inflammation

We investigated the evolution of serum klotho (s-Kl) and FGF-23 during the first two years post-kidney transplantation (KT), considering the cold ischemia time (CIT), glomerular filtration rate (GFR) and graft subclinical inflammation (SCI). We undertook a prospective, cohort, multicenter study of c...

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Detalles Bibliográficos
Autores: Hernández Marrero, Domingo Jerónimo, Vázquez Sánchez, Teresa, Sánchez Niño, María Dolores, Ruíz Esteban, Pedro, López, Verónica, León, Myriam, Caballero, Abelardo, Ruíz Escalera, Juan Francisco, Ortiz, Alberto, Torres, Armando, Rodríguez, Mariano
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universidad de La Laguna (ULL)
Repositorio:RIULL. Repositorio Institucional de la Universidad de La Laguna
OAI Identifier:oai:riull.ull.es:915/40238
Acceso en línea:http://riull.ull.es/xmlui/handle/915/40238
Access Level:acceso abierto
Palabra clave:kidney transplant
serum klotho levels
serum FGF-23 levels
graft function
graft subclinical inflammation
cold ischemia time
Descripción
Sumario:We investigated the evolution of serum klotho (s-Kl) and FGF-23 during the first two years post-kidney transplantation (KT), considering the cold ischemia time (CIT), glomerular filtration rate (GFR) and graft subclinical inflammation (SCI). We undertook a prospective, cohort, multicenter study of consecutive patients between April 2018 and January 2021 (with follow-up at 24 months). Subgroups were analyzed according to the median CIT (<14 vs. ≥14 h), the median GFR (≤40 vs. >40 mL/min/1.73 m2) and the presence of SCI at month 3. A total of 147 patients were included. s-Kl and fibroblast growth factor-23 (FGF-23) levels were measured at baseline and at months 3, 12 and 24. Graft biopsies (n = 96) were performed at month 3. All patients had low s-Kl levels at month 3. Patients with CIT < 14 h exhibited a significant increase in s-Kl at month 24. In patients with CIT ≥ 14 h, s-Kl at month 3 fell and lower s-Kl levels were seen at month 24. Patients with a GFR > 40 had a lesser decrease in s-Kl at month 3. FGF-23 fell significantly at months 3 and 12 in both GFR groups, a reduction maintained during follow-up. There were significant inter-group differences in s-Kl from months 3 to 24. CIT, GFR at 3 months and SCI were significantly associated with s-KI at month 3. A reduction in s-Kl at month 3 post-KT could be explained by longer CIT and delayed graft function as well as by impaired graft function. Early SCI may regulate s-Kl increase post-KT.