title: Decreased plasma α-Klotho predict progression of nephropathy with type 2 diabetic patients.
abstract: The potential role of soluble α-klotho in diabetic kidney disease has not yet been evaluated. The aim of this study was to evaluate the association of plasma and/or urine α-klotho with the progression of type 2 diabetic nephropathy.
  
  
  
  The baseline values of plasma and urine α-klotho were measured in 147 patients with type 2 diabetes mellitus with an estimated glomerular filtration rate (eGFR) of ≥60mL/min/1.73m(2). In this prospective observational study, a total of 109 type 2 diabetic patients were followed up for 34months (8-50 months).
  
  
  
  Plasma α-klotho, but not urine α-klotho, was negatively correlated with the decline of eGFR (r=-0.304, P=0.001; r=0.042, P=0.068, respectively). After adjusting for several clinical parameters, baseline eGFR and urine ACR, plasma α-klotho was significantly associated with the decline of eGFR (r=-0.219, P=0.008). In the normoalbuminuria group (n=63), the plasma α-klotho remained significantly associated with a decline in eGFR (r=0.324, P=0.004) in the final model.
  
  
  
  It is suggested that plasma α-klotho may be an early biomarker for predicting renal impairment in type 2 diabetic patients. The disappearance of a compensatory increase of plasma α-klotho might be a predictive marker for the progression of type 2 diabetic nephropathy.
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. Electronic address: injkim@pusan.ac.kr.
authors.forename: In Joo
authors.initials: IJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. Electronic address: eylee@sch.ac.kr.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Dong-A University Hospital, Busan, Korea.
authors.forename: Su Mi
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Choon Hee
authors.initials: CH
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: Ihm Soo
authors.initials: IS
authors.lastname: Kwak
authors.affiliation: Endocare Pharmacy, Busan, Korea.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Lee
authors.affiliation: Kim Yong Ki Internal Medicine Clinic, Busan, Korea.
authors.forename: Yong Ki
authors.initials: YK
authors.lastname: Kim
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000652:urine; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000209:etiology; D015415:Biomarkers / Q000097:blood / Q000652:urine; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000097:blood* / Q000503:physiopathology / Q000652:urine; D018450:Disease Progression; D015536:Down-Regulation; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005966:Glucuronidase / Q000097:blood* / Q000652:urine; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D000090265:Klotho Proteins; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000097:blood* / Q000150:complications / Q000503:physiopathology / Q000652:urine; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000652:urine; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D005966:Glucuronidase; D000090265:Klotho Proteins
keywords: Albuminuria; Chronic kidney disease; Diabetic nephropathy; Type 2 diabetes mellitus; α-Klotho