title: Klotho and chronic kidney disease.
abstract: Through alternative splicing, Klotho protein exists both as a secreted and a membrane form whose extracellular domain could be shed from the cell surface by secretases and released into the circulation to act as endocrine factor. Unlike membrane Klotho which functions as a coreceptor for fibroblast growth factor-23 (FGF23) to modulate FGF23 signal transduction, soluble Klotho is a multifunction protein present in the biological fluids including blood, urine and cerebrospinal fluid and plays important roles in antiaging, energy metabolism, inhibition of Wnt signaling, antioxidation, modulation of ion transport, control of parathyroid hormone and 1,25(OH)2VD3 production, and antagonism of renin-angiotensin-aldosterone system. Emerging evidence from clinical and basic studies reveal that chronic kidney disease is a state of endocrine and renal Klotho deficiency, which may serve as an early biomarker and a pathogenic contributor to chronic progression and complications in chronic kidney disease including vascular calcification, cardiac hypertrophy, and secondary hyperparathyroidism. Supplementation of exogenous Klotho and/or upregulation of endogenous Klotho production by using rennin angiotensin system inhibitors, HMG CoA reductase inhibitors, vitamin D analogues, peroxisome proliferator-activated receptors-gamma agonists, or anti-oxidants may confer renoprotection from oxidation and suppression of renal fibrosis, and also on prevention or alleviation of complications in chronic kidney disease. Therefore, Klotho is a highly promising candidate on the horizon as an early biomarker, and as a novel therapeutic agent for chronic kidney disease.
authors: Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
authors: Ming Chang
authors: MC
authors: Hu
authors: Makoto
authors: M
authors: Kuro-o
authors: Orson W
authors: OW
authors: Moe
mesh_terms: D000375:Aging / Q000378:metabolism; D000818:Animals; D002114:Calcinosis / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D009202:Cardiomyopathies / Q000209:etiology / Q000378:metabolism; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000378:metabolism; D004195:Disease Models, Animal; D018450:Disease Progression; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000502:physiology; D005966:Glucuronidase / Q000172:deficiency / Q000502:physiology*; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000378:metabolism; D000090265:Klotho Proteins; D008565:Membrane Proteins / Q000502:physiology; D009400:Nephrosclerosis / Q000209:etiology; D010281:Parathyroid Hormone / Q000378:metabolism; D010710:Phosphates / Q000378:metabolism; D051436:Renal Insufficiency, Chronic / Q000378:metabolism*; D012084:Renin-Angiotensin System / Q000502:physiology; D015398:Signal Transduction; D012995:Solubility; D014511:Uremia / Q000150:complications / Q000378:metabolism; D014807:Vitamin D / Q000378:metabolism
chemical_list: C000717427:FGF23 protein, human; D008565:Membrane Proteins; D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D005966:Glucuronidase; D000090265:Klotho Proteins; D002118:Calcium
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