RT info:eu-repo/semantics/article T1 Time dependent changes of klotho and fgf-23 levels after kidney transplantation: role of cold ischemia time, renal function and graft inflammation. A1 Hernández Marrero, Domingo Jerónimo A1 Vázquez Sánchez, Teresa A1 Sánchez Niño, María Dolores A1 Ruiz Estéban, Pedro A1 López, Veronica A1 León, Miriam A1 Caballero, Abelardo A1 Ruiz Escalera, Juan Francisco A1 Ortiz, Alberto A1 Torres, Armando A1 Rodríguez, Mariano K1 kidney transplant K1 serum klotho levels K1 serum FGF-23 levels K1 graft function K1 graft subclinical inflammation K1 cold ischemia time AB We investigated the evolution of serum klotho (s-Kl) and FGF-23 during the first two years post-kidney transplantation (KT), considering the cold ischemia time (CIT), glomerular filtration rate (GFR) and graft subclinical inflammation (SCI). We undertook a prospective, cohort, multicenter Academic Editor: Magdi Yaqoob Received: 2 June 2023 Revised: 23 June 2023 Accepted: 30 June 2023 Published: 4 July 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). study of consecutive patients between April 2018 and January 2021 (with follow-up at 24 months). Subgroups were analyzed according to the median CIT (<14 vs. ≥14 h), the median GFR (≤40 vs. >40 mL/min/1.73 m2) and the presence of SCI at month 3. A total of 147 patients were included. s-Kl and fibroblast growth factor-23 (FGF-23) levels were measured at baseline and at months 3, 12 and 24. Graft biopsies (n = 96) were performed at month 3. All patients had low s-Kl levels at month 3. Patients with CIT < 14 h exhibited a significant increase in s-Kl at month 24. In patients with CIT ≥14h,s-Kl at month 3fell and lower s-Kl levels were seen at month 24. Patients with a GFR > 40 had a lesser decrease in s-Kl at month 3. FGF-23 fell significantly at months 3 and 12 in both GFR groups, a reduction maintained during follow-up. There were significant inter-group differences in s-Kl from months 3 to 24. CIT, GFR at 3 months and SCI were significantly associated with s-KI at month 3. A reduction in s-Kl at month 3 post-KT could be explained by longer CIT and delayed graft function as well as by impaired graft function. Early SCI may regulate s-Kl increase post-KT. SN 2077-0383 YR 2023 FD 2023 LK http://riull.ull.es/xmlui/handle/915/39731 UL http://riull.ull.es/xmlui/handle/915/39731 LA en DS Repositorio institucional de la Universidad de La Laguna RD 27-abr-2025