| Title: |
Vitamin K supplementation to improve vascular stiffness in CKD: The K4Kidneys randomized controlled trial |
| Authors: |
Witham, Miles D.; Lees, Jennifer S.; White, Myra; Band, Margaret; Bell, Samira; Chantler, Donna J.; Ford, Ian; Fulton, Roberta L.; Kennedy, Gwen; Littleford, Roberta C.; McCrea, Ian V.; McGlynn, Deborah; Panarelli, Maurizio; Ralston, Maximilian R.; Rutherford, Elaine; Severn, Alison; Thomson, Nicola; Traynor, Jamie P.; Struthers, Allan D.; Wetherall, Kirsty; Mark, Patrick B. |
| Publisher Information: |
American Society of Nephrology |
| Publication Year: |
2020 |
| Collection: |
The University of Queensland: UQ eSpace |
| Subject Terms: |
arterial stiffness; chronic kidney disease; vascular calcification; vitamin K; 2727 Nephrology |
| Description: |
Background Vascular calcification, a risk factor for cardiovascular disease, is common among patients with CKD and is an independent contributor to increased vascular stiffness and vascular risk in this patient group. Vitamin K is a cofactor for proteins involved in prevention of vascular calcification. Whether or not vitamin K supplementation could improve arterial stiffness in patients with CKD is unknown. Methods To determine if vitamin K supplementation might improve arterial stiffness in patients in CKD, we conducted a parallel-group, double-blind, randomized trial in participants aged 18 or older with CKD stage 3b or 4 (eGFR 15-45 ml/min per 1.73 m). We randomly assigned participants to receive 400 mg oral vitamin K2 or matching placebo once daily for a year. The primary outcome was the adjusted between-group difference in carotid-femoral pulse wave velocity at 12 months. Secondary outcomes included augmentation index, abdominal aortic calcification, BP, physical function, and blood markers of mineral metabolism and vascular health. We also updated a recently published meta-analysis of trials to include the findings of this study. Results We included 159 randomized participants in the modified intention-to-treat analysis, with 80 allocated to receive vitamin K and 79 to receive placebo. Mean age was 66 years, 62 (39%) were female, and 87 (55%) had CKD stage 4. We found no differences in pulse wave velocity at 12 months, augmentation index at 12 months, BP, B-type natriuretic peptide, or physical function. The updated meta-analysis showed no effect of vitamin K supplementation on vascular stiffness or vascular calcification measures. Conclusions Vitamin K2 supplementation did not improve vascular stiffness or other measures of vascular health in this trial involving individuals with CKD. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
1533-3450; 1046-6673 |
| Relation: |
orcid:0000-0003-4868-0132; PG/14/75/31083 |
| Availability: |
https://espace.library.uq.edu.au/view/UQ:f6d4b5a |
| Accession Number: |
edsbas.2E1A923B |
| Database: |
BASE |