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Subject Area

Pediatrics

Article Type

Original Study

Abstract

Background Secondary hyperparathyroidism and bone fractures are common complications of chronic kidney diseases (CKD). Klotho (KL) protein is a coreceptor for fibroblast growth factor 23 and hence is involved in maintaining endocrine-system homeostasis and reduces cell death. Furthermore, KL is a valuable regulating factor in calcium/phosphate (Ca/P) metabolism. Objective To identify the KL polymorphism rs9536314 and its relationship with Ca/P metabolism and parathyroid-hormone (PTH) concentrations in children on regular hemodialysis (HD). Patients and methods A cross-sectional study was conducted for 6 months, from December 2020 to June 2021, on 50 pediatric patients with CKD on regular HD and an exact number (50) of apparently healthy children served as a control group after informed consent. The serum Ca, P, PTH, hemoglobin (Hb), and iron concentrations were measured. The KL polymorphism rs9536314 was identified by PCR–restriction-fragment length polymorphism. Results The results showed that the levels of serum Hb and Ca were significantly lower in the pediatric patients with CKD on regular HD group than in controls (P < 0.001). While P and PTH levels were higher in the patients' group (P < 0.001) than in the control group. Genotyping analysis of KL rs9536314 polymorphism (TT, TG, and GG) in the patient and control groups showed no significant difference between the two groups with regard to sex (P = 0.904), consanguinity (P = 0.239), Hb (P = 0.424), Ca (P = 0.783), P (P = 0.490), and PTH (P = 0.716). Conclusions There is no association between the KL polymorphism and Ca/P metabolism in pediatric patients with CKD on regular HD.

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