The Clinical Value of Klotho and FGF23 in Cardiac Valve Calcification Among Patients with Chronic Kidney Disease

Yan Chen, Yan-Xia Chen, Chong Huang, Zhi-Bing Duan, Cheng-Yun Xu Department of Nephrology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, People’s Republic of ChinaCorrespondence: Yan ChenDepartment of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Donghu District, Nanchang, Jiangxi Province, 330006, People’s Republic of ChinaTel/Fax +86 791 86312319Email chenyan_drcy@163.comObjective: This study aims to investigate the clinical value of serum Klotho and FGF23 in cardiac valve calcification in patients with chronic kidney disease (CKD).Methods: In the present study, 180 patients with CKD, who were admitted to the department of nephrology of our hospital on April 1, 2016 (solstice, 2019), were selected as the main subjects. According to the CKD stage, these patients were divided into three groups: CKD2∼ 3 group, CKD4 group, and CKD5 group. In each group, ultrasound was used to evaluate the cardiac valve calcification, and the independent risk factors for cardiac valve calcification were analyzed by Logistic regression.Results: The levels of hemoglobin and blood calcium in CKD2∼ 3 patients were higher than those in CKD4 and CKD5 patients, and the levels of hemoglobin and blood calcium in CKD5 patients were higher than those in CKD4 patients (P< 0.05). Albumin was lower in CKD2∼ 3 patients when compared to CKD5 patients while albumin was higher in CKD5 patients when compared to CKD4 patients (P< 0.05). The serum levels of FGF23 was lower in CKD2∼ 3 patients when compared to CKD4 and CKD5 patients while the serum levels of FGF23 was lower in CKD4 patients when compared to CKD5 patients (P< 0.05). The serum levels of Klotho was higher in CKD2∼ 3 patients, when compared to CKD4 and CKD5 patients, while the serum levels of Klotho was higher in CKD4 patients, when compared to CKD5 patients (P< 0.05). The logistic regression analysis revealed that GFR, serum creatinine, FGF23 and Klotho were independent risk factors for cardiac valve calcification in patients with CKD.Conclusion: With the decrease of GFR in CKD patients, the serum levels of FGF23 increases, while the serum levels of Klotho decreases. Furthermore, the serum levels of FGF23 and Klotho are affected by various factors, and the levels of FGF23 and Klotho in CKD patients are negatively correlated. GFR, serum creatinine, FGF23 and Klotho are independent risk factors for heart valve calcification in patients with CKD.Keywords: Klotho, FGF23, chronic kidney disease, cardiac valve calcification, logistic regression analysis