ArticleCritical care explorations2019
Urine Klotho Is Lower in Critically Ill Patients With Versus Without Acute Kidney Injury and Associates With Major Adverse Kidney Events.
Article in Critical care explorations, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
17 citing papers in PubMed, 26 citations in OpenAlex.
- Soluble average Klotho level as a prognostic marker for acute kidney injury outcomes: a 90-day follow-up study.Biomarkers in medicine · 2025Article
- Heterogeneity in the definition of major adverse kidney events: a scoping review.Intensive care medicine · 2024Article
- Exogenous Klotho Extends Survival in COVID-19 Model Mice.Pathogens (Basel, Switzerland) · 2023Article
- Article
- Research progress of fibroblast growth factor 23 in acute kidney injury.Pediatric nephrology (Berlin, Germany) · 2023Review
- Endocrinological disorders in acute kidney injury: an often overlooked field of clinical research.Journal of nephrology · 2023Review
- Partial Genetic Deletion of Klotho Aggravates Cardiac Calcium Mishandling in Acute Kidney Injury.International journal of molecular sciences · 2023Article
- Serum IL-17 levels are higher in critically ill patients with AKI and associated with worse outcomes.Critical care (London, England) · 2022Article
- The controversy of klotho as a potential biomarker in chronic kidney disease.Frontiers in pharmacology · 2022Review
- The Importance of Phosphate Control in Chronic Kidney Disease.Nutrients · 2021Review
- 25-hydroxyvitamin D, Fibroblast Growth Factor 23, and Risk of Acute Kidney Injury Over 20 Years of Follow-Up.Kidney international reports · 2021Article
- Fibroblast Growth Factor-23-Klotho Axis in Cardiorenal Syndrome: Mediators and Potential Therapeutic Targets.Frontiers in physiology · 2021Review
- Article
- Klotho in Clinical Nephrology: Diagnostic and Therapeutic Implications.Clinical journal of the American Society of Nephrology : CJASN · 2020Review
- Serum Klotho in Living Kidney Donors and Kidney Transplant Recipients: A Meta-Analysis.Journal of clinical medicine · 2020Article
- Acute Kidney Injury and Pediatric Bone Health.Frontiers in pediatrics · 2020Review
- Fibroblast Growth Factor 23 and αKlotho in Acute Kidney Injury: Current Status in Diagnostic and Therapeutic Applications.Nephron · 2020Review
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveKlotho and Fibroblast Growth Factor (FGF)-23 were recently postulated as candidate biomarkers and/or therapeutic targets in acute kidney injury (AKI). We examined whether urine Klotho and serum intact FGF23 levels were differentially and independently associated with major adverse kidney events (MAKE) in critically ill patients with and without AKI.
designSingle-center, prospective, case-control study.
settingICU in a tertiary medical center. PATIENTS: 54 AKI patients and 52 controls without AKI admitted to the ICU.
interventionsNone. MEASUREMENTS AND MAIN
resultsAKI was defined by KDIGO criteria and included only AKI stage ≥2. Controls were matched by age, gender, and baseline eGFR. Paired serum and urine samples were obtained 24-48h after AKI diagnosis (cases) or ICU admission (controls). The primary outcome was 90-day MAKE, which was the composite of all-cause death, dependence on renal replacement therapy or a 50% or higher decrease in eGFR from baseline. Forty-four (41.5%) patients developed MAKE-90. Patients who developed MAKE-90 had more comorbidity, higher acuity of illness scores and more prevalent AKI. Levels of urine Klotho adjusted by creatinine (Cr) were lower and serum intact FGF23 levels were higher in AKI patients vs. ICU controls. In adjusted models, the highest vs. lowest tertile of urine Klotho/Cr was independently associated with an overall 95% lower risk of MAKE-90 (81% lower risk in patients with AKI). The highest vs. lowest tertile of serum intact FGF23 was associated with >300% higher risk of MAKE-90.
conclusionsUrine Klotho/Cr levels were significantly lower and serum intact FGF23 levels significantly higher in critically ill patients with AKI vs. matched-controls without AKI. When measured in the first 48h of ICU admission or AKI diagnosis, urine Klotho/Cr independently associated with major adverse kidney events, particularly in patients with AKI. These results show promise for testing these biomarkers -individually or in combination- as part of novel risk-prediction models of renal outcomes in the ICU.
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