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Article Type

Original Study

Abstract

Introduction Chronic kidney disease–mineral bone disorder leads to decreasing bone health. Sclerostin is produced by osteocytes similar to fibroblast growth factor-23 (FGF-23) and might upregulate the FGF-23 production by the osteocyte. FGF-23 may act as a mineralization inhibitor. Klotho serves as an obligate coreceptor for the FGF-23 and represents a marker of chronic kidney disease–mineral bone disorder. Aim We examined the association between serum sclerostin, FGF-23, Klotho, parathyroid hormone, high-sensitivity C-reactive protein (hsCRP), and phosphorus levels in hemodialysis (HD) patients. Patients and methods A total of 63 HD patients in the National Institute of Urology and Nephrology and 20 controls were enrolled in the study. Serum sclerostin, FGF-23, Klotho, parathyroid hormone, hsCRP, and phosphorus levels were assayed. Results We found that serum sclerostin, FGF-23, Klotho, and hsCRP levels of the HD patients were higher than controls [median and interquartile range are 1.379 (0.217–11.680) ng/ml, 61.71 (9.821–565.5) pg/ml, 201.74 (90.53–402.73) pg/ml, and 25.79 (12.10–41.92) mg/l vs. 0.535 (0.169–0.830) ng/ml, 33.077 (10.45–67.342) pg/ml, 349.49 (201.23–721.5) pg/ml, and 4.375 (2.27–6.21), respectively; P < 0.001). The sclerostin level was significantly correlated with the serum phosphorus, FGF-23, Klotho, and hsCRP (r = 0.296, P < 0.007; r = 0.239, P = 0.03; r=−0.336, P = 0.002; and r = 0.469, P < 0.001, r espectively). Moreover, FGF-23 was significantly correlated with the serum phosphorus and hsCRP (r = 0.335, P = 0.002, and r = 0.379, P < 0.001, respectively). There were a significant negative correlation between serum Klotho and serum phosphorus, FGF-23, and hsCRP (r=−0.363, P < 0.001; r=−0.220, P = 0.046; and r=−0.881, P < 0.001, respectively). Conclusion There is an association between serum levels of sclerostin, phosphorus, and FGF-23 in HD patients, and Klotho may represent an early marker of renal damage.

Keywords

Fiboblast growth factor-23, hemodialysis, klotho, sclerostin

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