Klotho in Clinical Nephrology: Diagnostic and Therapeutic Implications.

Clinical Journal of the American Society of Nephrology : CJASN
Javier A NeyraOrson W Moe

Abstract

αKlotho (called Klotho here) is a membrane protein that serves as the coreceptor for the circulating hormone fibroblast growth factor 23 (FGF23). Klotho is also cleaved and released as a circulating substance originating primarily from the kidney and exerts a myriad of housekeeping functions in just about every organ. The vital role of Klotho is shown by the multiorgan failure with genetic deletion in rodents, with certain features reminiscent of human disease. The most common causes of systemic Klotho deficiency are AKI and CKD. Preclinical data on Klotho biology have advanced considerably and demonstrated its potential diagnostic and therapeutic value; however, multiple knowledge gaps exist in the regulation of Klotho expression, release, and metabolism; its target organs; and mechanisms of action. In the translational and clinical fronts, progress has been more modest. Nonetheless, Klotho has potential clinical applications in the diagnosis of AKI and CKD, in prognosis of progression and extrarenal complications, and finally, as replacement therapy for systemic Klotho deficiency. The overall effect of Klotho in clinical nephrology requires further technical advances and additional large prospective human studies.

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Citations

Oct 8, 2020·Cell Death and Differentiation·Fang ChenWangsen Cao
Nov 25, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Michael FreundlichBernardo Rodriguez-Iturbe
Jan 12, 2021·Hypertension·Mehmet KanbayAlberto Ortiz
Jan 23, 2021·International Journal of Molecular Sciences·Marlena Typiak, Agnieszka Piwkowska
Jun 3, 2021·Nutrients·Ken Tsuchiya, Taro Akihisa
Jun 19, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Dieter HaffnerMaren Leifheit-Nestler
Sep 25, 2021·Clinical Journal of the American Society of Nephrology : CJASN·David A DrewJavier A Neyra

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