Renal klotho expression in patients with acute kidney injury is associated with the severity of the injury

Min Young Seo, Jihyun Yang, Jun Yong Lee, Kitae Kim, Sun Chul Kim, Hyojeong Chang, Nam Hee Won, Myung Gyu Kim, Sang Kyung Jo, Wonyong Cho, Hyoung Kyu Kim

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31 Citations (Scopus)


Background/Aims: The potential physiologic roles of Klotho in acute kidney injury (AKI) have recently been demonstrated in animal models. However, to date, there have been no human studies investigating the expression of renal Klotho in AKI. Methods: We retrospectively collected biopsy specimens and clinical data of AKI patients between January 2001 and December 2012. Klotho expression was determined by immunohistochemical staining, and the clinical-pathological correlation was examined. Results: Among the 34 patients diagnosed with acute tubular necrosis or acute tubulointerstitial nephritis, 21 patients without chronic histological lesions were included. The mean age was 37.3 ± 18.5 years and the mean peak creatinine level was 8.2 ± 5.5 mg/dL. In total, 10 patients (47.6%) received temporary renal replacement therapy (RRT); however, 17 patients (81%) showed functional recovery with creatinine levels of < 1.3 mg/dL after 1 month. The intensity of Klotho expression was scored as a percentage of Klotho-positive area. The renal Klotho score showed a significant negative correlation with the initial or peak creatinine level. When the patients were divided into three groups according to the Klotho score (low, middle, high), the low group had a significantly higher peak creatinine level and a more frequent requirement for RRT. However, the Klotho score was not a significant predictor of renal recovery. Conclusions: The results demonstrated that renal Klotho expression in humans decreased significantly according to the severity of AKI, regardless of the etiology, and that low expression was associated with a poor short-term outcome.

Original languageEnglish
Pages (from-to)489-495
Number of pages7
JournalKorean Journal of Internal Medicine
Issue number4
Publication statusPublished - 2015 Jul 1
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015 The Korean Association of Internal Medicine.


  • Acute kidney injury
  • Acute tubular necrosis
  • Klotho

ASJC Scopus subject areas

  • Internal Medicine


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