title: Assessment of the relationship between serum soluble Klotho and carotid intima-media thickness and left ventricular dysfunction in hemodialysis patients.
abstract: BACKGROUND
  The aim of our study was to assess the relationship between soluble Klotho (s-Klotho) and carotid intima-media thickness (CIMT) and left ventricular (LV) dysfunction in hemodialysis (HD) patients.
  
  
  METHODS
  This is a cross-sectional study conducted on 88 patients with end-stage renal disease on regular HD. Serum levels of calcium, phosphorus, parathyroid hormone, and C-reactive protein were measured. The serum levels of s-Klotho and fibroblast growth factor-23 (FGF-23) were measured using an Enzyme linked immunosorbent assay (ELISA) kit. Echocardiography and measurement of CIMT were also conducted. The studied patients were divided according to the median s-Klotho level into 2 groups: patients with low s-Klotho (Group I) and patients with high s-Klotho (Group II).
  
  
  RESULTS
  Mean value of s-Klotho was significantly low in HD patients compared to controls (P = 0.001), and mean value of FGF-23 was significantly high in HD patients compared to controls (P = 0.001). The mean values of parathyroid hormone, FGF-23, and phosphorus were significantly high in Group I compared to Group II, whereas the mean value of serum calcium was significantly low in Group I compared to Group II. The mean values of CIMT, LV mass (LVM), LVM index, and LV ejection fraction (LVEF) were high in Group I compared to Group II. Patients with low s-Klotho had significantly more coronary artery disease (CAD). In a regression analysis of s-Klotho with different markers of cardiovascular diseases, s-Klotho showed significant association with CIMT, LVEF, and CAD, but not with LVM and LVM index.
  
  
  CONCLUSIONS
  The present study showed that patients with a low s-Klotho were more often associated with increased CIMT, LV dysfunction, and CAD, and it seems that there was independent association between s-Klotho and CIMT, LVEF, and CAD.
authors.affiliation: Department of Nephrology, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Emad
authors.initials: E
authors.lastname: Abdallah
authors.affiliation: Department of Nephrology, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Osama
authors.initials: O
authors.lastname: Mosbah
authors.affiliation: Department of Nephrology, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Ghada
authors.initials: G
authors.lastname: Khalifa
authors.affiliation: Department of Intensive Care Unit, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Amna
authors.initials: A
authors.lastname: Metwaly
authors.affiliation: Department of Clinical Chemistry, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Omnia
authors.initials: O
authors.lastname: El-Bendary
keywords: Cardiovascular diseases; End-stage renal disease; Fibroblast growth factor-23; Soluble Klotho