Elsevier

Transplantation Proceedings

Volume 45, Issue 1, January–February 2013, Pages 134-136
Transplantation Proceedings

Renal transplantation
Outcomes
The Impact of Nephrectomy and Renal Transplantation on Serum Levels of Soluble Klotho Protein

https://doi.org/10.1016/j.transproceed.2012.07.150Get rights and content

Abstract

Background

Klotho, a single-pass transmembrane protein primarily expressed in the kidneys, parathyroid glands, and choroid plexus of the brain, has a short cytoplasmic tail and a long extracellular domain, which can be cleaved and released as a soluble form. However, information regarding the origins and kinetics of soluble serum Klotho remains poorly understood. We evaluated serial changes in serum Klotho levels among living donors before and after retroperitoneoscopic nephrectomy as well as in their renal transplant recipients.

Methods

The levels of soluble Klotho in serum obtained from 10 living donors and their renal transplant recipients were determined using a sandwich enzyme-linked immunosorbent assay system.

Results

Serum soluble Klotho was detectable in all subjects. The baseline serum Klotho concentrations in the living donors ranged from 726.4 to 1417.1 pg/mL (median, 909.8 pg/mL; interquartile ranges [IR], 754.8–1132.4), whereas that in the concomitant renal transplant recipients ranged from 397.5 to 1047.2 pg/mL (median, 613.0 pg/mL; IR, 445.9–750.8; P = .003). The levels of soluble serum Klotho measured 5 days after retroperitoneoscopic nephrectomy (median, 619.0 pg/mL; IR, 544.6–688.5; P = .001) were significantly lower than the baseline values. Among the renal transplant recipients, no significant changes in serum Klotho levels were observed during the observation period.

Conclusion

Our data regarding soluble serum Klotho levels obtained from living donors support the idea that the kidneys are a major source of soluble serum Klotho in human subjects without a deterioration of renal function. In recipients, concomitant acute kidney injuries and immunosuppressive protocols might modulate the release of soluble Klotho from the grafts into the circulation.

Section snippets

Subjects and Methods

Between October 2011 and March 2012, 10 living donors and their concomitant renal transplant recipients were recruited for enrollment in this study. The research protocol was approved by our Medical Ethics Committee; all subjects provided informed consent. Soluble serum Klotho levels were determined 1 day before surgery (baseline), 2 days after surgery, as well as 5 days after surgery using a solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) kit (Immuno-Biological Laboratories,

Results

The clinical profiles of the living donors and renal transplant recipients are summarized in Table 1. Eight of 10 recipients had been previously treated with hemodialysis (HD) for a median of 3 years (IR, 2–8.5), and the remaining 2 subjects received transplants prior to commencing HD. Soluble serum Klotho was detectable in both groups. The baseline serum Klotho concentrations among the living donors ranged from 726.4 to 1417.1 pg/mL (median, 909.8 pg/mL; IR, 754.8–1132.4), whereas those of

Discussion

The number of subjects included in the present study was small, implying that this study was underpowered or may have overestimated the evaluation of clinical parameters. Nevertheless, our observations may help to improve understanding regarding the source and kinetics of soluble serum Klotho released by shedding of the enzymatic protein ectodomain.1 The serial data regarding soluble serum Klotho levels obtained from the living donors seemed to support the kidneys as a major source in human

References (12)

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Tetsu Akimoto was supported by a grant for pathophysiological research in chronic kidney disease from The Kidney Foundation, Japan (JKFB12-53).

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