Key result
Higher ePWV combined with lower serum Klotho is linked to ~85% higher CKD risk.
Why the study?
Older individuals typically exhibit greater arterial stiffness, lower serum Klotho levels, and higher CKD incidence, prompting evaluation of the interaction effect between ePWV and serum Klotho on CKD.
Does the combination of increased estimated pulse wave velocity and decreased serum Klotho levels associate with a higher prevalence of chronic kidney disease?
Cross-Sectional (n=13,273)
Does the combination of increased estimated pulse wave velocity and decreased serum Klotho levels associate with a higher prevalence of chronic kidney disease?
Odds Ratio: 1.847 (95% CI 1.467–2.325)
p-value: p=<0.001
The interaction between increased arterial stiffness (as measured by estimated pulse wave velocity) and lower serum Klotho levels is synergistically associated with a significantly higher prevalence of chronic kidney disease, highlighting their combined utility in risk stratification.
High ePWV with low Klotho associates with CKD cross-sectionally; leaves open causal roles and prospective utility for risk stratification.
Objectives Older individuals usually have greater arterial stiffness, lower serum Klotho levels and a greater incidence of chronic kidney disease (CKD). The current study aimed to evaluate the interaction effect of estimated pulse wave velocity (ePWV) and serum Klotho levels on CKD in Americans. Methods Data from the National Health and Nutrition Examination Survey database from 2007 to 2016 were used. Participants with data for the assessment of ePWV and serum Klotho and for the assessment of CKD were enrolled. The associations between ePWV and serum Klotho levels were analyzed via restricted cubic spline analysis and a linear regression model. The associations between exposure factors and CKD prevalence were assessed via a logistic regression model. Subgroup analysis was performed for each confounding factor to assess the robustness of the results. Results This study enrolled 13,273 participants, 3859 of whom were CKD patients. CKD patients had higher ePWV (9.66 ± 1.75 m/s vs. 8.48 ± 1.64 m/s, p < 0.001) and lower levels of serum Klotho (816.35 ± 290.47 pg/mL vs. 869.87 ± 315.87 pg/mL, p < 0.001). A significant negative linear association was found between ePWV and serum Klotho. According to the fully adjusted model, a significant interaction effect between ePWV and serum Klotho was observed on the risk of CKD ( p < 0.001). Compared with individuals with a lower ePWV and higher serum Klotho, individuals with an increased ePWV and lower serum Klotho had a significantly elevated risk of CKD (OR: 1.847, 95% confidence interval: 1.467–2.325; p < 0.001). The subgroup analysis revealed that the results were robust. Conclusions The study demonstrated significant interaction effect of ePWV and serum Klotho on the prevalence of CKD. Individuals with increased ePWV and decreased serum Klotho levels had the highest risk of CKD. The assessment of the combination of ePWV and serum Klotho for CKD management should be considered routine in clinical practice.
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Zou et al. (2025) conducted a cross-sectional in Chronic kidney disease (n=13,273). Increased estimated pulse wave velocity and decreased serum Klotho vs. Lower estimated pulse wave velocity and higher serum Klotho was evaluated on Prevalence of chronic kidney disease (OR 1.847, 95% CI 1.467-2.325, p=<0.001). Individuals with an increased estimated pulse wave velocity and lower serum Klotho levels had a significantly elevated risk of chronic kidney disease compared to those with lower ePWV and higher Klotho (OR 1.847, 95% CI 1.467-2.325).
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