대한신장학회

논문분류	춘계학술대회 초록집
제목	Serum klotho levels are associated with renal function recovery in patients with septic acute kidney injury undergoing continuous renal replacement therapy
저자	Young Eun Kwon* 1, Su-Young Jung1, Jong Hyun Jhee1, Seohyun Park1, Hae-Ryong Yun1, Hyoungnae Kim1, Youn Kyung Kee1, Chang-Yun Yoon1, Meiyan Wu2, Ji Min Park2, Jae Eun Um2, Seonghun Kim2, Hye-Young Kang2, Bo Young Nam2, Jung Tak Park1, Seung Hyeok Han1, Sh
출판정보	2016; 2016(1):
키워드	Continuous renal replacement therapy, Intensive care unit, Klotho, Mortality, Renal function, Septic acute kidney injury
초록	Background: Klotho is an anti-aging protein and previous studies have revealed that decreased serum klotho levels are associated with accelerated kidney damages from various renal injury. This study aimed to elucidate the role of klotho as a biomarker in septic acute kidney injury (AKI) patients requiring continuous renal replacement therapy (CRRT). Methods: This is a post hoc analysis of HICORES study (HIgh-volume COntinuous REnal replacement therapy in patients with Septic AKI, NCT 01191905) conducted from January 2011 to August 2014 at two tertiary hospitals in Korea. A total of 165 septic AKI patients undergoing CRRT were eligible and serum klotho level at CRRT initiation was measured by ELISA. The patients were divided into high and low klotho groups based on the median value of klotho (244 pg/ml). Primary outcome was 28-day all-cause mortality rate and secondary outcomes were the proportion of CRRT weaning and intensive care unit (ICU) discharge at 28 day. Multiple Cox regression analysis was performed to find the association between klotho level and study outcomes. Results: Male was 110 (66.7%) and the mean age was 62.2 years. High klotho group was younger and showed significantly lower norepinephrine requirement, C-reactive protein, and log transformed interleukin (IL)-1β and IL-10 level compared to low klotho group. Multiple Cox regression analysis revealed that the CRRT weaning rate at 28-day was significantly higher in high klotho group (hazard ratio [HR] 1.634; 95% confidence interval [CI] 1.004–2.659, P=0.048) compared to that in low klotho group. In addition, high klotho group showed more ICU discharges at 28-day (HR 2.959, 95% CI 1.493–5.864, P=0.002) than low klotho group after adjusting confounding factors. Meanwhile, the difference in all-cause mortality rate did not reach statistical significance between the two klotho groups (HR 0.709, 95% CI 0.480–1.049, P=0.085) Conclusion: Serum klotho levels were independently associated with the rate of CRRT weaning and ICU discharge in septic AKI patients requiring CRRT. Present study suggests that baseline klotho might be a potential biomarker predicting renal function recovery in patient with septic AKI.
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