Post-kidney transplant soluble Klotho levels are determined by pretransplant soluble Klotho levels in both living donors and recipients.

Soluble Klotho (sKl), the free form of membrane-bound Klotho predominantly expressed in the kidney, is detectable in serum and may have multiple pleiotropic effects. Patients with end-stage kidney disease are possibly sKl deficient, and kidney transplantation is the treatment of choice in these patients; however, little is known about changes in posttransplant sKl level and the factors influencing these changes. We conducted a prospective longitudinal study to examine changes in posttransplant sKl level in recipients for 12 months after living-donor kidney transplantation and analyzed correlations between posttransplant changes in sKl levels and various influencing factors in both recipients and donors. 29 kidney transplant recipients and their living donors were included for analysis. The results showed that sKl levels transiently decreased at 1 week posttransplant but progressively increased thereafter for 12 months. Multivariable linear regression analysis showed that body surface area-adjusted donor sKl levels were associated with posttransplant increases in recipient sKl levels at 12 months. In addition, pretransplant recipient sKl levels and body surface area-adjusted donor sKl levels were identified as an independent predictor of 12-month posttransplant sKl levels. Pretransplant sKl levels in both kidney recipients and living donors are a strong determinant of sKl levels after kidney transplantation.