Vitamin K supplementation and arterial calcification in dialysis: results of the double-blind, randomized, placebo-controlled RenaKvit trial
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Vitamin K supplementation and arterial calcification in dialysis : results of the double-blind, randomized, placebo-controlled RenaKvit trial. / Levy-Schousboe, Karin; Frimodt-Moller, Marie; Hansen, Ditte; Peters, Christian Daugaard; Kjaergaard, Krista Dybtved; Jensen, Jens Dam; Strandhave, Charlotte; Elming, Hanne; Larsen, Carsten Toftager; Sandstrom, Hanne; Brasen, Claus Lohman; Schmedes, Anne; Madsen, Jonna Skov; Jorgensen, Niklas Rye; Frokjaer, Jens Brondum; Frandsen, Niels Erik; Petersen, Inge; Marckmann, Peter.
In: Clinical Kidney Journal, Vol. 14, No. 9, 2021, p. 2114-2123.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Vitamin K supplementation and arterial calcification in dialysis
T2 - results of the double-blind, randomized, placebo-controlled RenaKvit trial
AU - Levy-Schousboe, Karin
AU - Frimodt-Moller, Marie
AU - Hansen, Ditte
AU - Peters, Christian Daugaard
AU - Kjaergaard, Krista Dybtved
AU - Jensen, Jens Dam
AU - Strandhave, Charlotte
AU - Elming, Hanne
AU - Larsen, Carsten Toftager
AU - Sandstrom, Hanne
AU - Brasen, Claus Lohman
AU - Schmedes, Anne
AU - Madsen, Jonna Skov
AU - Jorgensen, Niklas Rye
AU - Frokjaer, Jens Brondum
AU - Frandsen, Niels Erik
AU - Petersen, Inge
AU - Marckmann, Peter
PY - 2021
Y1 - 2021
N2 - Background. Arterial calcification is associated with cardiovascular mortality in dialysis patients. Active matrix Gla protein (MGP) is a vitamin K-dependent inhibitor of arterial calcification. Elevated plasma concentrations of inactive MGP, i.e. dephosphorylated-uncarboxylated MGP (dp-ucMGP), are prevalent in dialysis patients. MGP inactivity might contribute to arterial calcification. We investigated whether vitamin K supplementation had an effect on arterial calcification in chronic dialysis patients.Methods. In a 2-year, double-blind, placebo-controlled intervention trial, 48 dialysis patients were randomized to vitamin K [menaquinone-7 (MK-7), 360 mu g daily] or placebo. MK-7 in serum and dp-ucMGP in plasma were used to assess vitamin K status. Carotid-femoral pulse wave velocity (cfPWV) and scores of coronary arterial calcification (CAC) and abdominal aortic calcification (AAC) were used to assess arterial calcification.Results. Thirty-seven participants completed Year 1, and 21 completed Year 2. At Year 2, serum MK-7 was 40-fold higher, and plasma dp-ucMGP 40% lower after vitamin K supplementation compared with placebo {mean dp-ucMGP difference: -1380 pmol/L [95% confidence interval (CI) -2029 to -730]}. There was no significant effect of vitamin K supplementation on cfPWV [mean difference at Year 2: 1.2 m/s (95% CI -0.1 to 2.4)]. CAC Agatston score increased significantly in vitamin K supplemented participants, but was not significantly different from placebo [mean difference at Year 2: 664 (95% CI -554 to 1881)]. AAC scores increased in both groups, significantly so within the placebo group at Year 1, but with no significant between-group differences.Conclusions. Vitamin K supplementation improved vitamin K status, but did not hinder or modify the progression of arterial calcification in dialysis patients.
AB - Background. Arterial calcification is associated with cardiovascular mortality in dialysis patients. Active matrix Gla protein (MGP) is a vitamin K-dependent inhibitor of arterial calcification. Elevated plasma concentrations of inactive MGP, i.e. dephosphorylated-uncarboxylated MGP (dp-ucMGP), are prevalent in dialysis patients. MGP inactivity might contribute to arterial calcification. We investigated whether vitamin K supplementation had an effect on arterial calcification in chronic dialysis patients.Methods. In a 2-year, double-blind, placebo-controlled intervention trial, 48 dialysis patients were randomized to vitamin K [menaquinone-7 (MK-7), 360 mu g daily] or placebo. MK-7 in serum and dp-ucMGP in plasma were used to assess vitamin K status. Carotid-femoral pulse wave velocity (cfPWV) and scores of coronary arterial calcification (CAC) and abdominal aortic calcification (AAC) were used to assess arterial calcification.Results. Thirty-seven participants completed Year 1, and 21 completed Year 2. At Year 2, serum MK-7 was 40-fold higher, and plasma dp-ucMGP 40% lower after vitamin K supplementation compared with placebo {mean dp-ucMGP difference: -1380 pmol/L [95% confidence interval (CI) -2029 to -730]}. There was no significant effect of vitamin K supplementation on cfPWV [mean difference at Year 2: 1.2 m/s (95% CI -0.1 to 2.4)]. CAC Agatston score increased significantly in vitamin K supplemented participants, but was not significantly different from placebo [mean difference at Year 2: 664 (95% CI -554 to 1881)]. AAC scores increased in both groups, significantly so within the placebo group at Year 1, but with no significant between-group differences.Conclusions. Vitamin K supplementation improved vitamin K status, but did not hinder or modify the progression of arterial calcification in dialysis patients.
KW - chronic kidney disease
KW - coronary arterial calcification
KW - menaquinone-7
KW - pulse wave velocity
KW - CHRONIC KIDNEY-DISEASE
KW - MATRIX GLA PROTEIN
KW - PROGNOSTIC-SIGNIFICANCE
KW - VASCULAR CALCIFICATION
KW - CARDIOVASCULAR-DISEASE
KW - HEMODIALYSIS-PATIENTS
KW - STIFFNESS
KW - MORTALITY
KW - CALCIUM
KW - PROGRESSION
U2 - 10.1093/ckj/sfab017
DO - 10.1093/ckj/sfab017
M3 - Journal article
C2 - 34476095
VL - 14
SP - 2114
EP - 2123
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
SN - 0931-0509
IS - 9
ER -
ID: 281653130