The effect of sodium bicarbonate supplementation on serum alpha klotho in chronic kidney disease patients stage 3b to 4

Abstract

Growing evidence suggests that the FGF–Klotho endocrine system also has a crucial role in the pathophysiology of ageing-related disorders, including diabetes, cancer, arteriosclerosis and chronic kidney disease. Therefore, targeting the FGF–Klotho endocrine axes might have therapeutic benefit in multiple systems; investigation of the crystal structures of FGF–Klotho–FGFR complexes is paving the way for the development of drugs that can regulate these axes. FGF23 is a phosphaturic hormone; increased FGF23 levels in patients with early-stage chronic kidney disease or elderly individuals is indicative of excess phosphate intake relative to the residual nephron number. Serum levels of FGF21 increase in patients with CKD, as early as stage 2, and continue to rise with declining renal function. A few studies have reported that klotho deficiency is associated with hypertension, salt-sensitive hypertension, CKD, arterial stiffness, and cardiomyopathy. Therefore, evaluation of circulating Klotho concentrations or klotho genotypes could help identify patients at higher risk of developing age-related cardiovascular morbidities.