Korean J Intern Med.  2008 Dec;23(4):201-207. 10.3904/kjim.2008.23.4.201.

Polymorphism in the promoter region of the klotho gene (G-395A) is associated with early dysfunction in vascular access in hemodialysis patients

• Kim Y
• Jeong SJ
• Lee HS
• Kim EJ
• Song YR
• Kim SG
• Oh JE
• Lee YK
• Seo JW
• Yoon JW
• Koo JR
• Kim HJ
• Noh JW
• Park SH

• KMID: 1100768
• DOI: http://doi.org/10.3904/kjim.2008.23.4.201

Abstract

BACKGROUND/AIMS: Vascular access dysfunction is an important cause of morbidity and mortality in hemodialysis (HD) patients. Recent studies have shown that a klotho gene mutation is related to endothelial dysfunction, thrombosis, and arteriosclerosis, which are regarded as causes of vascular access dysfunction. We investigated the relationship between the klotho G-395A polymorphism and early dysfunction in vascular access in HD patients. METHODS: Patients who underwent vascular access operations between 1999 and 2002 were enrolled (n=126). Genotyping was performed by allelic discrimination using a 5'-nuclease polymerase chain reaction assay. Clinical data that could be relevant to access dysfunction were obtained from medical records. Early dysfunction of vascular access was defined as the need for any angioplastic or surgical intervention to correct or replace a poorly or nonfunctioning vascular access within 1 year and at least 8 weeks after initial access placement. RESULTS: Of the 126 patients, the genotype frequency of G-395A was 72.2% for GG (n=91), 24.6% for GA (n=31), and 3.2% for AA (n=4), and the frequency of minor allele was 0.155. Clinical data were similar between the two groups, divided according to the status of the A allele. Early dysfunction occurred in 34 (27.0%) of patients, but it occurred at a significantly higher rate in A allele carriers (45.7%, 16/35) than in noncarriers (19.8%, 18/91; p=0.003). CONCLUSIONS: Our results suggest that the klotho G-395A polymorphism could be a risk factor for early dysfunction of vascular access in HD patients.

Keyword

Klotho; Arteriovenous access; Hemodialysis

MeSH Terms

Aged
*Arteriovenous Shunt, Surgical
Catheters, Indwelling
Cohort Studies
Female
Glucuronidase/*genetics
Humans
Kidney Failure, Chronic/complications/*genetics/therapy
Male
Middle Aged
Polymorphism, Genetic/*genetics
Promoter Regions, Genetic/genetics
*Renal Dialysis
Vascular Diseases/complications/genetics
Vascular Patency/*genetics