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Associations of vitamin K status with mortality and cardiovascular events in peritoneal dialysis patients.
- Source :
-
International urology and nephrology [Int Urol Nephrol] 2019 Mar; Vol. 51 (3), pp. 527-534. Date of Electronic Publication: 2019 Jan 28. - Publication Year :
- 2019
-
Abstract
- Purpose: Vitamin K deficiency, expressed by a high level of desphospho-uncarboxylated matrix GLA protein (dp-ucMGP), is highly prevalent in dialysis patients. However, the predictive ability of the vitamin K status remains unclear in continuous ambulatory peritoneal dialysis (CAPD) patients.<br />Methods: 158 prevalent CAPD patients with a median level of dp-ucMGP of 1093 (752, 1485) pmol/L were enrolled. Patient outcomes including all-cause mortality and cardiovascular events (CVEs) were recorded during follow-up. Survival curves were performed using Kaplan-Meier method, and the influences of dp-ucMGP on outcomes were analyzed by Cox regression models.<br />Results: A total of 59 deaths and 82 new episodes of CVEs occurred during median follow-up of 31.4 ± 13.1 months (range: 3.8-48.0 months). Kaplan-Meier analysis revealed patients with higher dp-ucMGP levels (≥ 1093 pmol/L) had an increased risk for both mortality (P = 0.005) and CVEs (P < 0.001). Multivariable Cox regression confirmed that higher dp-ucMGP levels increase the mortality risk [hazard ratio (HR), 1.763; 95% CI 1.045-3.291] and CVEs (HR, 1.846; 95% CI 1.074-3.172). For every 100 pmol/L increase in serum dp-ucMGP, the adjusted HRs for mortality and CVEs were 1.054 (95% CI 1.008-1.106) and 1.034 (95% CI 1.012-1.089), respectively.<br />Conclusions: Vitamin K deficiency, as expressed by high dp-ucMGP levels, showed independently associations with mortality and CVEs in CAPD patients.
- Subjects :
- Adult
Aged
Calcium-Binding Proteins metabolism
Extracellular Matrix Proteins metabolism
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Kidney Failure, Chronic therapy
Male
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
Matrix Gla Protein
Cardiovascular Diseases blood
Cardiovascular Diseases epidemiology
Kidney Failure, Chronic blood
Kidney Failure, Chronic mortality
Peritoneal Dialysis, Continuous Ambulatory
Vitamin K Deficiency blood
Subjects
Details
- Language :
- English
- ISSN :
- 1573-2584
- Volume :
- 51
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International urology and nephrology
- Publication Type :
- Academic Journal
- Accession number :
- 30689181
- Full Text :
- https://doi.org/10.1007/s11255-019-02080-x