Klotho Protein as it Relates to Acute Kidney Injury (AKI)

Acute kidney injury (or AKI) is characterized by sudden kidney failure that develops as quickly as a few hours to within a few days. This collapse in kidney function can lead to long-term organ damage and even death. AKI is more common in older adults, especially those who are in the hospital or in the intensive care unit.

How Can Acute Kidney Injury Occur?

Decreased blood flow to the kidneys

When blood flow to the kidneys is reduced, this restricts the amount of oxygen carried to the kidneys and can cause tissue damage. This can occur for a number of reasons, including low blood pressure (or hypotension), surgery, or severe allergic reactions.

Kidney damage

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Damage to the kidneys inhibits these organs from properly filtering wastes from the bloodstream. Serious infections, cancer, vasculitis (a condition that causes inflammation and hardening of the blood vessels), or injury can all cause kidney damage.

Urinary tract obstruction

Certain conditions can cause blockages in the urethra and prevent urine from exiting the body. This causes a buildup of urine in either one or both of the kidneys, and can inhibit the kidneys’ ability to filter wastes from the bloodstream. The urinary tract can become obstructed due to cancer, kidney stones, blood clots, or an enlarged prostate.

Klotho protein deficiency

Scientists have discovered that individuals with acute kidney injury may have undetectable or very low levels of a protein called klotho. The klotho protein has been described as having an “anti-aging” property because it has been linked to the conservation of the proper function of multiple organ systems.

What is the Relationship Between Klotho Protein and Acute Kidney Injury?

Klotho protein can potentially be used as a marker to identify individuals who are at a higher risk of developing acute kidney injury after certain events such as major heart surgery. Since a deficiency in klotho protein has shown to possibly coincide with the occurrence of acute kidney injury, scientists are also researching the possibility of using klotho protein as a potential therapy for treatment of AKI.

Could Klotho Protein Be the Future of Acute Kidney Injury Prevention?

Currently, acute kidney injury is treated by:

  • Diet – adjusting one’s diet to one that is rich in carbohydrates and limits intake of protein, potassium, and salt may reduce the risk of waste buildup in the kidneys and the bloodstream.
  • Medications – medications may be prescribed in order to prevent infection and help the kidneys remove liquids.
  • Dialysis – In dialysis, a machine is used to filter wastes from the patient’s blood. The blood passes through the machine, and filtered blood is then returned to the body.

Researchers are currently exploring the ability to use klotho protein as a treatment option for individuals who experience acute kidney injury. One study attempted to restore kidney function in rats after they had experienced injury caused by a lack of blood and oxygen to the organs. The rats who were treated with klotho protein experienced significant improvement in kidney function, as opposed to rats who did not receive klotho protein treatment and did not see an increase in kidney function.

Scientists will continue to research the safety and efficacy of klotho protein as a potential treatment for AKI, which may provide patients with more treatment options and the possibility to restore kidney function after experiencing AKI.

Sources:

  1. Klotho in acute kidney injury: biomarker, therapy, or a bit of both? Aiello S et al., Kidney international. 2010
  2. Klotho: a novel and early biomarker of acute kidney injury after cardiac valve replacement surgery in adults Yong-Jun Liu et al., Int J Clin Exp Med 2015
  3. Klotho deficiency is an early biomarker of renal ischemia–reperfusion injury and its replacement is protective Ming-Chang Hu et al., Kidney International 2010
  4. Hu, M. and Moe, O. (2012). Klotho as a potential biomarker and therapy for acute kidney injury. Nature Reviews Nephrology, 8(7), pp.423-429.
  5. Emedicine.medscape.com. (2018). Acute Kidney Injury: Practice Essentials, Background, Pathophysiology. [online] Available at: https://emedicine.medscape.com/article/243492-overview#a6 [Accessed 18 Jan. 2018].
  6. Astutemedical.com. (2018). [online] Available at: http://www.astutemedical.com/wp-content/uploads/2015/07/AKI_Fact_Sheet_PN-0104_RevD.pdf [Accessed 18 Jan. 2018].
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