{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:08:35Z","timestamp":1768867715579,"version":"3.49.0"},"reference-count":40,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2019,3,27]],"date-time":"2019-03-27T00:00:00Z","timestamp":1553644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Background: Research over the past decade has focused on the role of Klotho as a cardio protective agent that prevents the effects of aging on the heart and reduces the burden of cardiovascular disease CVD. The role of the interaction between fibroblast growth factor 23-(FGF-23)\/Klotho in Klotho-mediated actions is still under debate. The main objective was to ascertain the potential use of plasmatic Klotho and FGF23 as markers for CKD-associated cardiac disease and mortality. Methods: This was a prospective analysis conducted in an outpatient diabetic nephropathy clinic, enrolling 107 diabetic patients with stage 2\u20133 CKD. Patients were divided into three groups according to their left ventricular mass index and relative wall thickness. Results: Multinomial regression analysis demonstrated that low Klotho and higher FGF-23 levels were linked to a greater risk of concentric hypertrophy. In the generalized linear model (GLM), Klotho, FGF-23 and cardiac geometry groups were statistically significant as independent variables of cardiovascular hospitalization (p = 0.007). According to the Cox regression model, fatal cardiovascular events were associated with the following cardiac geometric classifications; eccentric hypertrophy (p = 0.050); concentric hypertrophy (p = 0.041), and serum phosphate \u2265 3.6 mg\/dL (p = 0.025), FGF-23 \u2265 168 (p = 0.0149), \u03b1-klotho &lt; 313 (p = 0.044). Conclusions: In our population, Klotho and FGF23 are associated with cardiovascular risk in the early stages of CKD.<\/jats:p>","DOI":"10.3390\/ijms20071536","type":"journal-article","created":{"date-parts":[[2019,3,29]],"date-time":"2019-03-29T03:38:52Z","timestamp":1553830732000},"page":"1536","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Plasmatic Klotho and FGF23 Levels as Biomarkers of CKD-Associated Cardiac Disease in Type 2 Diabetic Patients"],"prefix":"10.3390","volume":"20","author":[{"given":"Ana Paula","family":"Silva","sequence":"first","affiliation":[{"name":"Nephrology Department, Centro Hospitalar Universit\u00e1rio do Algarve, 800-836 Faro, Portugal"},{"name":"Departamento de Ci\u00eancias Biom\u00e9dicas e Medicina, Universidade do Algarve, 8005-139 Faro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0329-8805","authenticated-orcid":false,"given":"Filipa","family":"Mendes","sequence":"additional","affiliation":[{"name":"Nephrology Department, Centro Hospitalar Universit\u00e1rio do Algarve, 800-836 Faro, Portugal"}]},{"given":"Eduarda","family":"Carias","sequence":"additional","affiliation":[{"name":"Nephrology Department, Centro Hospitalar Universit\u00e1rio do Algarve, 800-836 Faro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4373-5379","authenticated-orcid":false,"given":"Rui Baptista","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Departamento de Ci\u00eancias Biom\u00e9dicas e Medicina, Universidade do Algarve, 8005-139 Faro, Portugal"}]},{"given":"Andr\u00e9","family":"Fragoso","sequence":"additional","affiliation":[{"name":"Nephrology Department, Centro Hospitalar Universit\u00e1rio do Algarve, 800-836 Faro, Portugal"}]},{"given":"Carolina","family":"Dias","sequence":"additional","affiliation":[{"name":"Departamento de Ci\u00eancias Biom\u00e9dicas e Medicina, Universidade do Algarve, 8005-139 Faro, Portugal"}]},{"given":"Nelson","family":"Tavares","sequence":"additional","affiliation":[{"name":"Cardiology Department, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"Hugo Mendon\u00e7a","family":"Caf\u00e9","sequence":"additional","affiliation":[{"name":"Cardiology Department, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"N\u00e9lio","family":"Santos","sequence":"additional","affiliation":[{"name":"Clinic Pathology Department, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-836, Faro, Portugal"}]},{"given":"F\u00e1tima","family":"Rato","sequence":"additional","affiliation":[{"name":"Clinic Pathology Department, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-836, Faro, Portugal"}]},{"given":"Pedro","family":"Le\u00e3o Neves","sequence":"additional","affiliation":[{"name":"Nephrology Department, Centro Hospitalar Universit\u00e1rio do Algarve, 800-836 Faro, Portugal"},{"name":"Departamento de Ci\u00eancias Biom\u00e9dicas e Medicina, Universidade do Algarve, 8005-139 Faro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0702-4569","authenticated-orcid":false,"given":"Edgar","family":"Almeida","sequence":"additional","affiliation":[{"name":"Faculdadade de Medicina da Universidade de Lisboa, 1600-190 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2019,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1053\/j.ajkd.2013.12.006","article-title":"GFR Estimation: From Physiology to Public Health","volume":"63","author":"Levey","year":"2014","journal-title":"Am. 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