The Clinical Value of Klotho and FGF23 in Cardiac Valve Calcification Among Patients with Chronic Kidney Disease

Figures & data

Table 1 The Relationship Between Clinical Data and the CKD Stages of Patients

CKD Stages	CKD 2–3	CKD 4	CKD 5	P
Cases(n)	60	60	60
Gender(M/F)	38/22	41/19	34/26	0.419
Average age(Y)	54±13	56±12	58±15	0.265
Hemoglobin(g/L)	102.55±23.82	86.68±17.33	90.52±23.36	0.000
Albumin(g/L)	32.63±7.20	33.57±5.34	36.61±4.37	0.001
Urea(mmol/L)	10.20±5.19	18.41±8.15	24.08±10.11	0.000
Serum creatinine(umol/L)	230.61±185.52	491.72±215.32	845.09±334.18	0.000
GFR(mL/min)	47.04±14.00	21.84±5.01	10.14±2.13	0.000
Blood uric acid(umol/L)	360.67±100.35	440.81±169.23	574.33±95.34	0.000
B2 microglobulin(mg/L)	8.57±5.41	13.28±4.03	16.52±3.47	0.000
Correction of calcium(mmol/L)	2.38±0.10	2.23±0.12	2.06±0.15	0.000
Blood phosphorus(mmol/L)	1.22±0.27	1.59±0.42	1.92±0.56	0.000
Blood magnesium(mmol/L)	0.91±0.15	0.95±0.16	1.00±0.18	0.015
Osteocalcin(ng/mL)	47.99±35.82	104.43±73.22	197.32±78.88	0.000
PTH(pg/mL)	131.13±90.41	254.01±184.68	392.40±233.88	0.005
Serum 25-hydroxyvitamin D(ng/mL)	18.17±10.22	20.55±16.03	25.12±14.93	0.023
Osseous ALP(U/L)	77.27±11.56	81.33±15.15	86.36±18.18	0.005
Klotho(U/L)	159.05±27.53	127.58±16.85	87.06±15.14	0.000
FGF23(pg/mL)	494.60±64.85	721.17±92.05	1039.43±213.83	0.000

Figure 1 The relationship between calcium and phosphorus metabolism indexes and the CKD stages.

Figure 2 The relationship between bone metabolism indicators and the CKD stages.

Figure 3 The relationship between FGF23, Klotho expression and the CKD stages.

Table 2 Influencing Factor Analysis of Serum FGF23 Expression in CKD Patients

Index	r	P
Klotho(U/L)	−0.836	<0.05
Osteocalcin(ng/mL)	0.563	<0.05
PTH(pg/mL)	0.348	<0.05
Serum 25-hydroxyvitamin D(ng/mL)	0.207	0.005
Osseous ALP(U/L)	0.213	0.004
Blood phosphorus(mmol/L)	0.462	<0.05
Correction of calcium(mmol/L)	−0.579	<0.05
B2 microglobulin(mg/L)	0.495	<0.05
GFR(mL/min)	−0.718	<0.05
Albumin(g/L)	0.249	0.001
Age(Y)	0.179	0.016
Blood uric acid(umol/L)	0.496	<0.05
Serum creatinine(umol/L)	0.58	<0.05
Blood magnesium(mmol/L)	0.224	0.003

Table 3 Influencing Factor Analysis of Serum Klotho Expression in CKD Patients

Index	r	P
FGF23(pg/mL)	−0.836	<0.05
Osteocalcin(ng/mL)	−0.581	<0.05
PTH(pg/mL)	−0.378	<0.05
Osseous ALP(U/L)	−0.181	0.015
Blood phosphorus(mmol/L)	−0.487	<0.05
Correction of calcium(mmol/L)	0.562	<0.05
B2 microglobulin(mg/L)	−0.486	<0.05
GFR(mL/min)	0.721	<0.05
Albumin(g/L)	−0.186	0.012
Blood uric acid(umol/L)	−0.493	<0.05
Serum creatinine(umol/L)	−0.573	<0.05

Table 4 Index Analysis of CKD Patients with Cardiac Valve Calcification and CKD Patients without Cardiac Valve Calcification

Index	Non-Cardiac Valve Calcification Group	Cardiac Valve Calcification Group	P
FGF23(pg/mL)	657.7±15.69	1070.54±37.59	<0.05
Klotho(U/L)	136.11±2.66	85.44±2.99	<0.05
Osteocalcin(ng/mL)	105.63±7.58	153.7±12.76	0.002
Blood phosphorus(mmol/L)	1.54±0.04	1.72±0.09	0.04
B2 microglobulin(mg/L)	12.27±0.47	14.57±0.73	0.017
Correction of calcium(mmol/L)	2.25±0.02	2.17±0.03	0.021
Age (Y)	55.37±1.19	60.37±1.84	0.039
Albumin(g/L)	33.89±0.52	35.6±0.8	0.108
Urea(mmol/L)	16.72±0.78	20.43±1.79	0.034
Serum creatinine(umol/L)	488.51±29.46	637.62±57.45	0.018
GFR(mL/min)	29.25±1.56	16.51±1.63	<0.05
Blood uric acid(umol/L)	438.8±12.46	525.79±24.7	0.001
Blood magnesium(mmol/L)	0.95±0.01	0.98±0.03	0.311

Table 5 Risk Factor Analysis of Cardiac Valve Calcification in CKD Patients

Index	B	SE	Wald	OR(95% CI)	P
GFR	0.082	0.028	8.513	1.085(1.027–1.147)	0.004
Serum creatinine	−0.004	0.001	10.015	0.996(0.993–0.998)	0.002
FGF23	0.012	0.004	10.500	1.012(1.005–1.019)	0.001
Klotho	−0.072	0.024	9.428	0.930(0.888–0.974)	0.002