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2017 ; 91
(5
): 1104-1114
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Recombinant ?-Klotho may be prophylactic and therapeutic for acute to chronic
kidney disease progression and uremic cardiomyopathy
#MMPMID28131398
Hu MC
; Shi M
; Gillings N
; Flores B
; Takahashi M
; Kuro-O M
; Moe OW
Kidney Int
2017[May]; 91
(5
): 1104-1114
PMID28131398
show ga
?-Klotho is highly expressed in the kidney, and its extracellular domain is
cleaved and released into the circulation. Chronic kidney disease (CKD) is a
state of ?-Klotho deficiency, which exerts multiple negative systemic effects on
numerous organs including the cardiovascular system. Since acute kidney injury
(AKI) greatly escalates the risk of CKD development, we explored the effect of
?-Klotho on prevention and treatment on post-AKI to CKD progression and
cardiovascular disease. Therein, ischemia reperfusion injury-induced AKI was
followed by early administration of recombinant ?-Klotho or vehicle starting one
day and continued for four days after kidney injury (CKD prevention protocol). A
CKD model was generated by unilateral nephrectomy plus contralateral ischemia
reperfusion injury. Late administration of ?-Klotho in this model was started
four weeks after injury and sustained for 12 weeks (CKD treatment protocol). The
prevention protocol precluded AKI to CKD progression and protected the heart from
cardiac remodeling in the post-AKI model. One important effect of exogenous
?-Klotho therapy was the restoration of endogenous ?-Klotho levels long after the
cessation of exogenous ?-Klotho therapy. The treatment protocol still effectively
improved renal function and attenuated cardiac remodeling in CKD, although these
parameters did not completely return to normal. In addition, ?-Klotho
administration also attenuated high phosphate diet-induced renal and cardiac
fibrosis, and improved renal and cardiac function in the absence of pre-existing
renal disease. Thus, recombinant ?-Klotho protein is safe and efficacious, and
might be a promising prophylactic or therapeutic option for prevention or
retardation of AKI-to-CKD progression and uremic cardiomyopathy.