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2015 ; 26
(5
): 1150-60
Nephropedia Template TP
gab.com Text
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Soluble Klotho Protects against Uremic Cardiomyopathy Independently of Fibroblast
Growth Factor 23 and Phosphate
#MMPMID25475745
Xie J
; Yoon J
; An SW
; Kuro-o M
; Huang CL
J Am Soc Nephrol
2015[May]; 26
(5
): 1150-60
PMID25475745
show ga
Cardiac hypertrophy occurs in up to 95% of patients with CKD and increases their
risk for cardiovascular death. In the kidney, full-length membranous Klotho forms
the coreceptor for fibroblast growth factor 23 (FGF23) to regulate phosphate
metabolism. The prevailing view is that the decreased level of Klotho in CKD
causes cardiomyopathy through increases in serum FGF23 and/or phosphate levels.
However, we reported recently that soluble Klotho protects against cardiac
hypertrophy by inhibiting abnormal calcium signaling in the heart. Here, we
tested whether this protective effect requires changes in FGF23 and/or phosphate
levels. Heterozygous Klotho-deficient CKD mice exhibited aggravated cardiac
hypertrophy compared with wild-type CKD mice. Cardiac magnetic resonance imaging
studies revealed that Klotho-deficient CKD hearts had worse functional impairment
than wild-type CKD hearts. Normalization of serum phosphate and FGF23 levels by
dietary phosphate restriction did not abrogate the aggravated cardiac hypertrophy
observed in Klotho-deficient CKD mice. Circulating levels of the cleaved soluble
ectodomain of Klotho were lower in wild-type CKD mice than in control mice and
even lower in Klotho-deficient CKD mice. Intravenous delivery of a transgene
encoding soluble Klotho ameliorated cardiac hypertrophy in Klotho-deficient CKD
mice. These results suggest that the decreased level of circulating soluble
Klotho in CKD is an important cause of uremic cardiomyopathy independent of FGF23
and phosphate, opening new avenues for treatment of this disease.