Renal klotho expression in patients with acute kidney injury is associated with the severity of the injury

Min Young Seo, Jihyun Yang, Jun Yong Lee, Kitae Kim, Sun Chul Kim, Hyojeong Chang, Nam Hee Won, Myung-Gyu Kim, Sang Kyung Jo, Won Yong Cho, Hyoung Kyu Kim

Research output: Contribution to journalArticle

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Abstract

Background/Aims: The potential physiologic roles of Klotho in acute kidney injury (AKI) have recently been demonstrated in animal models. However, to date, there have been no human studies investigating the expression of renal Klotho in AKI. Methods: We retrospectively collected biopsy specimens and clinical data of AKI patients between January 2001 and December 2012. Klotho expression was determined by immunohistochemical staining, and the clinical-pathological correlation was examined. Results: Among the 34 patients diagnosed with acute tubular necrosis or acute tubulointerstitial nephritis, 21 patients without chronic histological lesions were included. The mean age was 37.3 ± 18.5 years and the mean peak creatinine level was 8.2 ± 5.5 mg/dL. In total, 10 patients (47.6%) received temporary renal replacement therapy (RRT); however, 17 patients (81%) showed functional recovery with creatinine levels of < 1.3 mg/dL after 1 month. The intensity of Klotho expression was scored as a percentage of Klotho-positive area. The renal Klotho score showed a significant negative correlation with the initial or peak creatinine level. When the patients were divided into three groups according to the Klotho score (low, middle, high), the low group had a significantly higher peak creatinine level and a more frequent requirement for RRT. However, the Klotho score was not a significant predictor of renal recovery. Conclusions: The results demonstrated that renal Klotho expression in humans decreased significantly according to the severity of AKI, regardless of the etiology, and that low expression was associated with a poor short-term outcome.

Original languageEnglish
Pages (from-to)489-495
Number of pages7
JournalKorean Journal of Internal Medicine
Volume30
Issue number4
DOIs
Publication statusPublished - 2015 Jul 1

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Acute Kidney Injury
Kidney
Creatinine
Wounds and Injuries
Renal Replacement Therapy
Necrosis
Animal Models
Staining and Labeling
Biopsy

Keywords

  • Acute kidney injury
  • Acute tubular necrosis
  • Klotho

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Renal klotho expression in patients with acute kidney injury is associated with the severity of the injury. / Seo, Min Young; Yang, Jihyun; Lee, Jun Yong; Kim, Kitae; Kim, Sun Chul; Chang, Hyojeong; Won, Nam Hee; Kim, Myung-Gyu; Jo, Sang Kyung; Cho, Won Yong; Kim, Hyoung Kyu.

In: Korean Journal of Internal Medicine, Vol. 30, No. 4, 01.07.2015, p. 489-495.

Research output: Contribution to journalArticle

Seo, Min Young ; Yang, Jihyun ; Lee, Jun Yong ; Kim, Kitae ; Kim, Sun Chul ; Chang, Hyojeong ; Won, Nam Hee ; Kim, Myung-Gyu ; Jo, Sang Kyung ; Cho, Won Yong ; Kim, Hyoung Kyu. / Renal klotho expression in patients with acute kidney injury is associated with the severity of the injury. In: Korean Journal of Internal Medicine. 2015 ; Vol. 30, No. 4. pp. 489-495.
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AU - Chang, Hyojeong

AU - Won, Nam Hee

AU - Kim, Myung-Gyu

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AB - Background/Aims: The potential physiologic roles of Klotho in acute kidney injury (AKI) have recently been demonstrated in animal models. However, to date, there have been no human studies investigating the expression of renal Klotho in AKI. Methods: We retrospectively collected biopsy specimens and clinical data of AKI patients between January 2001 and December 2012. Klotho expression was determined by immunohistochemical staining, and the clinical-pathological correlation was examined. Results: Among the 34 patients diagnosed with acute tubular necrosis or acute tubulointerstitial nephritis, 21 patients without chronic histological lesions were included. The mean age was 37.3 ± 18.5 years and the mean peak creatinine level was 8.2 ± 5.5 mg/dL. In total, 10 patients (47.6%) received temporary renal replacement therapy (RRT); however, 17 patients (81%) showed functional recovery with creatinine levels of < 1.3 mg/dL after 1 month. The intensity of Klotho expression was scored as a percentage of Klotho-positive area. The renal Klotho score showed a significant negative correlation with the initial or peak creatinine level. When the patients were divided into three groups according to the Klotho score (low, middle, high), the low group had a significantly higher peak creatinine level and a more frequent requirement for RRT. However, the Klotho score was not a significant predictor of renal recovery. Conclusions: The results demonstrated that renal Klotho expression in humans decreased significantly according to the severity of AKI, regardless of the etiology, and that low expression was associated with a poor short-term outcome.

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