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Factors that downregulate renal Klotho in CKD setting
| Loss of functional kidney mass |
|---|
| Abnormal cytokine production |
| TNF-α ↑ |
| IFN-γ ↑ |
| Oxidative stress |
| H2O2 ↑ |
| Lipid peroxidation ↑ |
| Over activation of renal RAS |
| Ang II ↑ |
| Abnormal hormone |
| 1,25-VD3 ↓ |
| Disturbed mineral metabolism |
| Pi overload |
| Blood Pi ↑ |
| Small uremic toxin |
| Indoxyl sulphate ↑ |
