The Association of Klotho G-395A Gene Polymorphism with Cardiovascular Complications in Pediatric Patients with End Stage Renal Diseases.

Introduction: Chronic kidney disease (CKD) results in irreversible loss of kidney function, often progressing to end-stage renal disease (ESRD). Hemodialysis remains the primary life-sustaining therapy for pediatric ESRD patients. However, these children face a significantly increased risk of cardiovascular disease (CVD), which accounts for over 20% of deaths and a 30-fold higher mortality rate compared to healthy peers. Klotho, a transmembrane protein primarily secreted by the kidneys, plays a critical role in phosphate regulation, calcitriol synthesis, and vascular health. Its gene expression in vascular tissues suggests a potential influence on cardiovascular outcomes.Aim of the Study: To evaluate the association between Klotho G-395A gene polymorphism and cardiovascular complications in pediatric ESRD patients on hemodialysis..Methods: This case-control study included two groups: pediatric ESRD patients receiving regular hemodialysis and age-matched healthy controls. Informed consent was obtained from all parents or guardians. The study was conducted at the pediatric nephrology unit of our university hospital between May and December 2022, with ethical approval from the university’s research committee.Results: The GA+AA genotypes of the Klotho G-395A polymorphism were significantly more prevalent in ESRD patients (55%) than controls (11%). These genotypes were associated with a 17-fold increased risk of cardiovascular complications. Carriers of the A allele had a 9-fold higher risk of cardiovascular events compared to G allele carriers.Conclusion: The Klotho G-395A polymorphism is a significant genetic risk factor and potential biomarker for cardiovascular complications in pediatric hemodialysis patients.