Klotho in diabetes and diabetic nephropathy: a brief update review

The growing data demonstrate that Klotho (KL) is deeply implicated in the diabetic nephropathy. The circulating form of α-Klotho (α-KL) named as soluble KL functions as an endocrine substance that exerts heterogeneous actions including the modulation of renal function upon hyperglycemia, regulation of cell compensation, downgrade inflammation and anti-oxidation. There is a positive correlation between progression of renal disease/other complications and systemic KL deficiency in diabetes mellitus patients. Restoration by exogenous supplementation or stimulation of endogenous KL may prevent and/or ameliorate kidney injury and mitigate development of diabetes mellitus. KL signaling is intertwined with mTOR, NF-κB, Wnt and PPAR-γ. KL can possibly emerge on the horizon as a candidate for an unprecedented sole biomarker and intervention in patients with diabetes mellitus or the complication like diabetic nephropathy.