Association Between Klotho and Cardiac Abnormalities in Pre-dialysis CKD Patients

Introduction The onset and progression of chronic kidney disease (CKD) are strongly linked to a decrease in Klotho, which was once thought to have an anti-aging effect. The specific mechanism of this enzyme’s connection with CKD and its related co-morbidities has to be investigated further. Present study aimed to test Klotho levels in various phases of CKD and to study their correlation with cardiac morbidity. Methods Present study was single-center, observational, cross-sectional study conducted in all genders with age ≥18 years who presented with CKD stages G1-G5 ND. All cases underwent battery of investigations including estimation of serum Klotho & FGF 23 levels along with 2D echocardiography. Results Most study participants were found to be in CKD stage G2 (24%) followed by stages G4 and G5 (18% each). On cardiac evaluation, low LVEF was detected in 38% cases, diastolic dysfunction in 44% & LV hypertrophy in 48% cases. There was a negative correlation between serum Klotho levels and LVH ( P = .009), LVEF ( P = .015) or LV diastolic dysfunction ( P = .005). Likewise, there was positive correlation between serum FGF 23 levels and LVH ( P = .0001), LVEF ( P = .0001) or LV diastolic dysfunction ( P = .0001). Conclusions With our study, we want to emphasize the prognostic value of Klotho and FGF 23 in routine evaluation of CKD patients. Low serum Klotho & high FGF 23 levels were associated with low left ventricular ejection fraction (LVEF), left ventricular hypertrophy (LVH) and left ventricular dysfunction among CKD patients.