Inhibition of the Mammalian Target of Rapamycin May Augment the Increase in Soluble Klotho Levels in Renal Transplantation Recipients

Blood Purif. 2019;47 Suppl 2:12-18. doi: 10.1159/000496630. Epub 2019 Apr 3.


Background/aims: α-Klotho is mainly expressed in the kidneys, and its soluble form can prevent vascular calcifications. Inhibition of the mammalian target of rapamycin (mTOR) upregulates Klotho. We assessed serial changes in the levels of soluble Klotho (sKlotho) in recipients before and after renal transplantation and investigated the effects of an mTOR inhibitor.

Methods: Serum sKlotho levels were measured in 36 recipients before and 1 year after transplantation and compared between those taking everolimus and those not taking everolimus.

Results: sKlotho levels were higher after transplantation than before transplantation (369.3 vs. 211.8 pg/mL). After transplantation, sKlotho levels were significantly higher in recipients taking everolimus than in those not taking everolimus (536.7 vs. 332.4 pg/mL).

Conclusion: Our results suggest that mTOR inhibition may augment the increase in sKlotho levels in transplant recipients. Further studies are needed to examine whether mTOR inhibitors suppress the development of vascular complications via upregulation of Klotho expression in renal transplant recipients.

Keywords: End-stage renal disease; Everolimus; Klotho; Mammalian target of rapamycin inhibitor; Renal transplantation.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Everolimus / therapeutic use*
  • Female
  • Glucuronidase / blood*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Transplantation* / methods
  • Klotho Proteins
  • Male
  • Middle Aged
  • Retrospective Studies
  • TOR Serine-Threonine Kinases / antagonists & inhibitors*


  • Immunosuppressive Agents
  • Everolimus
  • MTOR protein, human
  • TOR Serine-Threonine Kinases
  • Glucuronidase
  • Klotho Proteins