{"id":"661ebbdadfb1","type":"article","url":"https://hartvaat.nl/2026/10/01/lage-serum-klotho-correleert-met-vasculaire-schade-bij-chronische-nierziekte/","title":"Lage serum-Klotho correleert met vasculaire schade bij chronische nierziekte","title_en":"The Interplay Between Klotho, Aldosterone, and Vascular Damage in Chronic Kidney Disease: Insights from a Cross-Sectional Study.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","internist"],"tags":[],"journal":"Journal of nephrology","doi":"10.1093/joneph/aajag249","source_url":"https://doi.org/10.1093/joneph/aajag249","authors":["Lida Tartaglione","Silverio Rotondi","Marzia Pasquali","Adolfo Perrotta","Francesca Tinti","Antonella Zaccaria","Viviana Beatriz Quiñonez","Federico Andreetti","Valeria Fassino","Silvia Lai","Claudio Letizia","Luigi Petramala","Francesco Circosta","Gianluigi Zaza","Sandro Mazzaferro"],"significance":4,"published":"2026-10-09","source_date":"2026-10-01","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/nierziekte/nsaids-en-nierziekte/"],"congress":"","summary_en":"A cross-sectional study of 55 patients with chronic kidney disease (CKD) found that serum Klotho levels progressively declined as eGFR decreased. This decline correlated negatively with markers of vascular damage, including CAVI and intima-media thickness. Although aldosterone was elevated in advanced CKD (stages G4-5), it showed no direct association with vascular parameters, and multivariate analysis identified age as the primary determinant of CAVI. These findings support an independent link between Klotho deficiency and vascular complications in CKD, offering mechanistic insights into cardiorenal risk stratification, though direct therapeutic implications remain limited.","created":"2026-10-02T01:35:22Z","updated":"2026-10-02T01:35:22Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een cross-sectioneel onderzoek bij 55 patiënten met chronische nierziekte (CKD) daalde het serum-Klotho-niveau progressief naarmate de eGFR afnam. Deze daling correleerde negatief met matigen van vasculaire schade, zoals gemeten met de CAVI en IMT. Hoewel aldosteron in gevorderd CKD (stadia G4-5) verhoogd was, had dit geen directe associatie met vasculaire parameters; multivariaat analyse wees leeftijd aan als belangrijkste determinant van CAVI. De bevindingen ondersteunen een onafhankelijk verband tussen Klotho-tekort en vasculaire complicaties bij CKD, wat relevant is voor het in kaart brengen van cardiorenale risico's, al blijft de klinische vertaalslag naar nieuwe interventies voorlopig beperkt.","abstract_original":"BACKGROUND: Patients with chronic kidney disease (CKD) are at increased risk of vascular calcification and cardiovascular mortality. Reduced Klotho levels have been associated with vascular damage in CKD through both direct and indirect mechanisms. Klotho deficiency, a hallmark of CKD, has been suggested to contribute to the hyperaldosteronism observed in CKD. This study aimed to evaluate the relationship between serum Klotho (s-Klotho), aldosterone, and vascular damage in CKD. METHODS: We studied 55 patients with CKD stages G1-5 (52.0, IQR: 39.0-63.0 y; 27 M/28 F; eGFR 53.1±31.7 ml/min). Vascular damage was assessed non-invasively using the cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), and intima-media thickness (IMT). s-Klotho and aldosterone levels were measured. A control group of 38 age- and sex-matched hypertensive patients without CKD was used for comparison of vascular parameters. RESULTS: CAVI values in CKD patients were pathological (8.4±1.2) but did not differ from controls. s-Klotho levels progressively declined across CKD stages (p for trend <0.001) and correlated positively with eGFR, while showing negative associations with age and vascular parameters (CAVI, ABI, and IMT). s-Klotho also correlated with aldosterone, whose levels were elevated only in advanced CKD (stages G4-5) and showed no association with vascular parameters. Multivariate analysis identified age as the only independent determinant of CAVI; s-Klotho emerged as an independent predictor only in models excluding age. CONCLUSION: s-Klotho levels progressively decline in CKD and are associated with vascular damage, supporting an association between Klotho deficiency and vascular damage that appears independent of aldosterone."}