Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;53(3):e13903.
doi: 10.1111/eci.13903. Epub 2022 Dec 1.

Alpha-klotho and peritoneal membrane status: A hypothesis generating study

Patrícia Branco  1   2 , Ana Rita Martins  1 , Rita Calça  1 , Catarina Mateus  1 , Maria João Jervis  3 , Anabela Rodrigues  4   5 , Sofia Azeredo Lopes  6   7 , Ester Civantos  8 , Sebastian Mas-Fontao  8 , Augusta Gaspar  1 , Sância Ramos  9 , Judit Morello  2 , Daniel Pinto Gomes  9 , Sofia Azeredo Pereira  2
Affiliations

Alpha-klotho and peritoneal membrane status: A hypothesis generating study

Patrícia Branco et al. Eur J Clin Invest. 2023 Mar.

Abstract

Background: Long-term success of peritoneal dialysis relies on the integrity of the peritoneal membrane. This proof-of-concept study addressed the hypothesis that fibrosis is already present in the membrane at pre-dialysis and that the membrane status is related to the individual's uraemic fingerprint.

Methods: A clinical-mechanistic, transversal, single-centre study was conducted. Pre-dialysis peritoneal biopsies were scored considering the submesothelial compact zone thickness (STM), vasculopathy and inflammation. We investigated if the membrane status could be inferred from a panel of proteins (α-Klotho, Galectin-3, FGF21, FGF23, Tweak, TNFα and hsPCR) in blood.

Results: A total 58 incident patients aged 56 ± 15 years old were included, 31% female, 55% hypertension, 29% diabetic and 24% obese. Person-to-person STM was found to be highly variable and 38% of patients were fibrosis positive. Both α-Klotho (Spearman r = -.7491, p < 0.001) and FGF21 (Spearman r = -.5102, p < 0.001) were negatively associated with STM. α-Klotho, but not FGF21, was able to discriminate fibrosis from nonfibrosis with/without inflammation and vasculopathy. PLS models identified α-Klotho as the protein most relevant for fibrosis. α-Klotho was independently associated with fibrosis of the peritoneal membrane (OR = .991 (.896-.997), p = 0.002).

Conclusion: Before the start of dialysis in incident patients, some patients already present fibrosis of the peritoneal membrane and other patients do not. Our findings suggest that α-Klotho may be implicated in fibrosis of the peritoneal membrane.

Keywords: biopsy; cytokines; diabetes; peritoneal membrane fibrosis; precision medicine; uraemic toxins.

PubMed Disclaimer

References

REFERENCES

    1. Yeates K, Zhu N, Vonesh E, Trpeski L, Blake P, Fenton S. Hemodialysis and peritoneal dialysis are associated with similar outcomes for end-stage renal disease treatment in Canada. Nephrol Dial Transplant. 2012;27(9):3568-3575.
    1. Escoli R, Carvalho MJ, Cabrita A, Rodrigues A. Diastolic dysfunction, an underestimated new challenge in dialysis. Ther Apher Dial. 2019;23(2):108-117.
    1. Cho Y, Bello AK, Levin A, et al. Peritoneal dialysis use and practice patterns: an international survey study. Am J Kidney Dis. 2021;77(3):315-325.
    1. Kunin M, Beckerman P. The peritoneal membrane-a potential mediator of fibrosis and inflammation among heart failure patients on peritoneal dialysis. Membranes. 2022;12(3):318.
    1. Silva F, Calça R, Martins AR, et al. Is peritoneal dialysis an effective treatment for cardiorenal syndrome with decompensated heart failure? A single center experience. Med Clin Res. 2022;7(2):12-17.

LinkOut - more resources