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| Relationship between serum klotho protein level and nutritional status in hemodialysis patients |
| LI Jia1 WEI Shanzhai1 SUN Jie1 WANG Yu2 LIU Yitong2 |
1.Department of Nephrology, Shuyang Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province, Shuyang 223600, China;
2.Department of Nutrition，Shuyang Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province, Shuyang 223600, China |
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Abstract Objective To investigate the relationship between serum Klotho protein level and nutritional status in hemodialysis patients. Methods A total of 113 patients with end-stage renal disease admitted to Shuyang Affiliated Hospital of Traditional Chinese Medicine of Nanjing University (“our hospital” for short) from March 2016 to December 2018 were selected as observation group. According to the modified subjective comprehensive nutrition assessment (MQSGA), the observation group was divided into group A (well-nourished, 32 cases), group B (mild to moderate malnutrition, 48 cases), and group C (severe malnutrition, 33 cases). Another 90 healthy volunteers examined in our hospital during the same period were selected as control group. The anthropological indicators, serological indicators and nutritional status between two groups were compared. Pearson correlation was used to analyze the correlation between Klotho protein and anthropological indicators, serological indicators and nutritional status. Results The body mass index (BMI), skin fold thickness (TSF), upper arm circumference (MAMC), albumin (Alb), hemoglobin (Hb) and klotho protein in the observation group were lower than those in the control group, and the differences were statistically significant (P ＜ 0.05), while serum creatinine (Scr), urea nitrogen (BUN), parathyroid hormone (PTH), fibroblast growth factor 23 (FGF-23), MQSGA were higher than those of the control group, and the differences were statistically significant (P ＜ 0.05). Comparison of various indicators of hemodialysis patients with different levels of malnutrition, and the differences were statistically significant (P ＜ 0.05). Klotho protein was positively correlated with TSF, MAMC, Alb and Hb in hemodialysis patients (r = 0.642，0.446，0.453，0.536，P ＜ 0.05), however, it negatively correlated with Scr, BUN, PTH, FGF-23 and MQSGA scores (r = -0.392，-0.382，-0.412，-0.439，-0.526，P ＜ 0.05). Conclusion There is a low expression of serum klotho protein in hemodialysis patients, and the expression level is closely related to the nutritional status of patients. It can be considered clinically as a new direction for treating hemodialysis patients with malnutrition.
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