Abstract
BackgroundHemodialysis patients suffer from a serious threat of cerebrovascular disease. Klotho, as an aging-suppressor gene, contributes to protect on vascular calcification and oxidative stress, which are the risk factors of cerebrovascular disease. The purpose of the present study is to determine the relationship between serum klotho and cerebrovascular disease in patients receiving hemodialysis.MethodsSerum klotho levels of hemodialysis patients were measured by ELISA. Cerebrovascular diseases were diagnosed by CT or MRI scans. The cognitive function of hemodialysis patients with cerebrovascular disease were evaluated with a neuropsychological battery assessing domains of global cognition verbal memory, spatial memory, executive function and verbal fluency.ResultsEighty-eight patients were included, 57 ± 14 years, 63.64% male, 52.27% older than 60 years. Twenty-eight participants had cerebrovascular disease (23 cases had cerebral infarction, 5 cases had cerebral hemorrhage). The average level of serum klotho of all participants was 119.10 ± 47.29 pg/ml. The serum klotho level was significantly associated with cerebrovascular disease in hemodialysis patients (HR(95%CI) = 0.975(0.960–0.990), p = 0.001). The optimal cut-off value of serum klotho for predicting cerebrovascular disease in hemodialysis patients was 137.22 pg/ml, with a specificity of 96.4% and a sensitivity of 46.7%. But serum klotho was not an independent risk factor of cognitive impairment for hemodialysis patients with cerebrovascular disease (HR((95%CI) = 1.002(0.986–1.018), p = 0.776) or with cerebral infarction (HR(95%CI) = 1.005(0.987–1.023), p = 0.576).ConclusionsThe serum klotho level is a potential predictor of cerebrovascular disease in hemodialysis patients, but it is not an independent risk factor of cognitive impairment for hemodialysis patients with cerebrovascular disease.
Highlights
Hemodialysis patients suffer from a serious threat of cerebrovascular disease
A total of 88 hemodialysis patients were included for the current study, and 56(63.64%) cases were male
The results showed that serum klotho (HR(95%95% confidence interval (CI)) = 0.975(0.960–0.990), p = 0.001) and age (HR(95%CI) = 1.104(1.038–1.174), p = 0.002) were the independent risk factors of cerebrovascular disease in hemodialysis patients
Summary
Hemodialysis patients suffer from a serious threat of cerebrovascular disease. The purpose of the present study is to determine the relationship between serum klotho and cerebrovascular disease in patients receiving hemodialysis. With the Hemodialysis is associated with raised risk of cardiovascular disease (CVD), infection, cerebrovascular. The risk of cerebrovascular disease in patients receiving hemodialysis is six to ten times higher than in the general population [2]. Cerebrovascular disease is the third leading cause of death for patients on dialysis [3]. Cerebrovascular disease is prevalent in hemodialyis patients partly related to the traditional risk factors, such as age, hypertension, diabetes mellitus and dyslipidemia. The uremic and dialysis process itself the independent risk factors for cerebrovascular disease [7, 8]
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