Circulating Levels of Soluble α-Klotho and FGF23 in Childhood Cancer Survivors: Lack of Association with Nephro- and Cardiotoxicity—A Preliminary Study

Author:

Kozłowski Kacper1,Konończuk Katarzyna1ORCID,Muszyńska-Rosłan Katarzyna1ORCID,Żelazowska-Rutkowska Beata2ORCID,Taranta-Janusz Katarzyna3ORCID,Werbel Katarzyna4,Krawczuk-Rybak Maryna1,Latoch Eryk1ORCID

Affiliation:

1. Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-274 Białystok, Poland

2. Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, 15-274 Białystok, Poland

3. Department of Pediatrics and Nephrology, Medical University of Bialystok, 15-274 Białystok, Poland

4. Department of Neonatology, Pathology and Newborn Intensive Care, Jędrzej Śniadecki Independent Public Healthcare Center—Regional Hospital, 15-027 Białystok, Poland

Abstract

Background/Objectives: The survival rate among pediatric cancer patients has reached 80%; however, these childhood cancer survivors (CCSs) are at a heightened risk of developing chronic conditions in adulthood, particularly kidney and cardiovascular diseases. The aims of this study were to assess the serum α-Klotho and FGF23 levels in CCSs and to determine their association with nephro- and cardiotoxicity. Methods: This study evaluated a cohort of 66 CCSs who remained in continuous remission, with a mean follow-up of 8.41 ± 3.76 years. Results: The results of this study revealed that CCSs exhibited significantly higher levels of soluble α-Klotho compared to healthy peers (1331.4 ± 735.5 pg/mL vs. 566.43 ± 157.7 pg/mL, p < 0.0001), while no significant difference was observed in their FGF23 levels. Within the participant cohort, eight individuals (12%) demonstrated a reduced estimated glomerular filtration rate (eGFR) below 90 mL/min/1.73 m2. The relationship between treatment with abdominal radiotherapy and reduced eGFR was confirmed (p < 0.05). No correlations were found between potential treatment-related risk factors, such as chemotherapy or radiation therapy, serum levels of α-Klotho and FGF23, and nephro- and cardiotoxicity. Conclusions: In conclusion, this preliminary cross-sectional study revealed elevated levels of α-Klotho among childhood cancer survivors but did not establish a direct association with anticancer treatment. The significance of elevated α-Klotho protein levels among CCSs warrants further investigation.

Publisher

MDPI AG

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