Circulating α-Klotho and Multidimensional Aging and Frailty Outcomes: A Systematic Review and Meta-Analysis from the European Renal Association CKD-MBD Working Group.

Mustafa Guldan, Lasin Ozbek, Derya G Fidan, Arif E Narin, Ditte Hansen, Juan M Diaz-Tocados, Mathias Haarhaus, Martin H de Borst, Carlo Alfieri, Pietro M Ferraro, Antonio Bellasi, Mehmet Kanbay

School of Medicine, Koç University, Istanbul, Turkey.School of Medicine, Koç University, Istanbul, Turkey. · pubmed

Paper

Abstract

Although α-Klotho has gained attention as a promising biomarker of aging, its association with frailty and broader aging-related outcomes beyond chronic kidney disease-mineral and bone disorder remains incompletely characterized. This systematic review and meta-analysis aimed to investigate the association between circulating α-Klotho levels and aging-related outcomes, including frailty, effects of physical activity and exercise interventions, body composition, cognitive and neuropsychiatric status, sarcopenia, and bone mineral density (BMD). A comprehensive literature search was performed across multiple electronic databases, including Ovid MEDLINE, Web of Science, Scopus, PubMed, and the Cochrane Library, to identify relevant studies published up to April 30, 2025. Pooled analyses were conducted using random-effects models, with effect estimates synthesized as mean differences, odds ratios, or correlation coefficients, and heterogeneity assessed using the I

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Research summary

The paper investigates the association between circulating α-Klotho levels and various aging-related outcomes. The focus on α-Klotho as a biomarker for aging and its potential implications for understanding frailty and other aging-related conditions contributes to the broader discourse on aging and longevity.

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