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Post-kidney transplant soluble Klotho levels are determined by pretransplant soluble Klotho levels in both living donors and recipients

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Abstract

Background

Soluble Klotho (sKl), the free form of membrane-bound Klotho predominantly expressed in the kidney, is detectable in serum and may have multiple pleiotropic effects. Patients with end-stage kidney disease are possibly sKl deficient, and kidney transplantation is the treatment of choice in these patients; however, little is known about changes in posttransplant sKl level and the factors influencing these changes.

Methods

We conducted a prospective longitudinal study to examine changes in posttransplant sKl level in recipients for 12 months after living-donor kidney transplantation and analyzed correlations between posttransplant changes in sKl levels and various influencing factors in both recipients and donors.

Results

29 kidney transplant recipients and their living donors were included for analysis. The results showed that sKl levels transiently decreased at 1 week posttransplant but progressively increased thereafter for 12 months. Multivariable linear regression analysis showed that body surface area-adjusted donor sKl levels were associated with posttransplant increases in recipient sKl levels at 12 months. In addition, pretransplant recipient sKl levels and body surface area-adjusted donor sKl levels were identified as an independent predictor of 12-month posttransplant sKl levels.

Conclusion

Pretransplant sKl levels in both kidney recipients and living donors are a strong determinant of sKl levels after kidney transplantation.

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Acknowledgements

We thank Chigusa Ishioka for her help with sample measurement.

Funding

This work was supported in part by JSPS KAKENHI (grant no. JP 25461962) and also by a grant from The Kidney Foundation, Japan (no. JKFB18-29 to Dr. Nakamura). The founder had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript. We also thank the Tokai University General Research Organization for funding the editing and proofreading of this paper.

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Authors and Affiliations

  1. Department of Transplant Surgery, Tokai University School of Medicine, Isehara, Japan

    Hiroaki Ishida, Michio Nakamura, Saeko Uehara & Shinya Takiguchi

  2. Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Japan

    Hirotaka Komaba & Masafumi Fukagawa

Authors
  1. Hiroaki Ishida
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  2. Michio Nakamura
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  3. Hirotaka Komaba
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  4. Saeko Uehara
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  5. Shinya Takiguchi
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  6. Masafumi Fukagawa
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Contributions

HI and MN designed the study. HI analyzed the data. HI, MN, SU, ST, HK, and MF performed the study. HI wrote the paper.

Corresponding author

Correspondence to Michio Nakamura.

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Conflict of interest

Dr. Nakamura received grant support from Astellas Pharma and Novartis. Dr. Komaba has received honoraria, consulting fees, and/or grant support from Bayer Yakuhin, Chugai Pharmaceutical, Japan Tobacco, Kyowa Kirin, Novartis, and Ono Pharmaceutical. Dr. Fukagawa has received honoraria, consulting fees, and/or grant support from Bayer Yakuhin, Chugai Pharmaceutical, Fresenius Kabi, Kissei Pharmaceutical, Kyowa Kirin, Ono Pharmaceutical, and Torii Pharmaceutical. The remaining authors declare no competing interests.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at which the studies were conducted (IRB approval number 13R015) and with the 1964 Helsinki declaration and its later amendments of comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Ishida, H., Nakamura, M., Komaba, H. et al. Post-kidney transplant soluble Klotho levels are determined by pretransplant soluble Klotho levels in both living donors and recipients. Clin Exp Nephrol 25, 1367–1374 (2021). https://doi.org/10.1007/s10157-021-02112-w

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  • DOI: https://doi.org/10.1007/s10157-021-02112-w

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