Functional vitamin K insufficiency, vascular calcification and mortality in advanced chronic kidney disease: A cohort study

Lu Dai*, Longkai Li, Helen Erlandsson, Armand M G Jaminon, Abdul Rashid Qureshi, Jonaz Ripsweden, Torkel B Brismar, Anna Witasp, Olof Heimbürger, Hanne Skou Jørgensen, Peter Barany, Bengt Lindholm, Pieter Evenepoel, Leon J Schurgers, Peter Stenvinkel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Web of Science)

Abstract

Patients with chronic kidney disease (CKD) suffer from vitamin K deficiency and are at high risk of vascular calcification (VC) and premature death. We investigated the association of functional vitamin K deficiency with all-cause mortality and whether this association is modified by the presence of VC in CKD stage 5 (CKD G5). Plasma dephosphorylated-uncarboxylated matrix Gla-protein (dp-ucMGP), a circulating marker of functional vitamin K deficiency, and other laboratory and clinical data were determined in 493 CKD G5 patients. VC was assessed in subgroups by Agatston scoring of coronary artery calcium (CAC) and aortic valve calcium (AVC). Backward stepwise regression did not identify dp-ucMGP as an independent determinant of VC. During a median follow-up of 42 months, 93 patients died. Each one standard deviation increment in dp-ucMGP was associated with increased risk of all-cause mortality (sub-hazard ratio (sHR) 1.17; 95% confidence interval, 1.01-1.37) adjusted for age, sex, cardiovascular disease, diabetes, body mass index, inflammation, and dialysis treatment. The association remained significant when further adjusted for CAC and AVC in sub-analyses (sHR 1.22, 1.01-1.48 and 1.27, 1.01-1.60, respectively). In conclusion, functional vitamin K deficiency associates with increased mortality risk that is independent of the presence of VC in patients with CKD G5.

Original languageEnglish
Article number0247623
Pages (from-to)e0247623
Number of pages17
JournalPLOS ONE
Volume16
Issue number2
DOIs
Publication statusPublished - 24 Feb 2021

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