Suboptimal vitamin K status and its risk factors in a population of Chinese chronic haemodialysis patients

Nephrology (Carlton). 2015 Sep;20(9):625-31. doi: 10.1111/nep.12494.

Abstract

Aims: Vitamin K deficiency is known to be common in haemodialysis patients and associates with adverse outcomes in this population, particularly vascular calcification. We aimed to investigate the vitamin K status in a population of Chinese haemodialysis (HD) patients.

Methods: We collected demographic and biochemical data from a population of maintenance HD (MHD) patients in our unit and a control group composed of healthy subjects from our outpatient clinic. Fasting serum samples from all subjects were collected for the measurement of known vitamin K-dependent proteins i.e. matrix Gla protein (MGP), osteocalcin (OC) and uncarboxylated osteocalcin (ucOC). We also quantified the fraction of ucOC to total OC (%ucOC). Differences of these parameters between groups were analyzed and risk factors of vitamin K deficiency based on the definition as per %ucOC were investigated.

Results: We enrolled 93 MHD patients as a test group and 93 healthy subjects as a control group. There was no significant difference in MGP between groups (4.0 ± 2.8 pg/mL in MHD vs 4.2 ± 1.2 pg/mL in control; P = 0.676). Mean %ucOC was significantly greater in the MHD patients as compared to control subjects (76.4 ± 20.0% in MHD vs 48.56 ± 15.5%; P < 0.001). Time on dialysis and low-density lipoprotein cholesterol level appeared to be indicators of vitamin K deficiency, with the former being an independent risk factor.

Conclusions: Defining Vitamin K deficiency by %ucOC, suboptimal vitamin K levels appear common in Chinese MHD patients. Time on dialysis and LDL cholesterol level predict vitamin K deficiency.

Keywords: carboxylation; haemodialysis; osteocalcin; risk factor; vitamin K deficiency.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Calcium-Binding Proteins / blood
  • Case-Control Studies
  • China / epidemiology
  • Cholesterol, LDL / blood
  • Cross-Sectional Studies
  • Extracellular Matrix Proteins / blood
  • Female
  • Humans
  • Kidney Diseases / blood
  • Kidney Diseases / diagnosis
  • Kidney Diseases / epidemiology
  • Kidney Diseases / therapy*
  • Male
  • Matrix Gla Protein
  • Middle Aged
  • Osteocalcin / blood
  • Renal Dialysis / adverse effects*
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Vitamin K Deficiency / blood
  • Vitamin K Deficiency / diagnosis
  • Vitamin K Deficiency / epidemiology*

Substances

  • Biomarkers
  • Calcium-Binding Proteins
  • Cholesterol, LDL
  • Extracellular Matrix Proteins
  • Osteocalcin