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Associations of vitamin K status with mortality and cardiovascular events in peritoneal dialysis patients

  • Qingdong XuEmail author
  • Huankai Guo
  • Shirong Cao
  • Qian Zhou
  • Jiexin Chen
  • Ming Su
  • Siying Chen
  • Songqin Jiang
  • Xiaofeng Shi
  • Yueqiang Wen
Nephrology - Original paper
  • 16 Downloads

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.

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.

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.

Conclusions

Vitamin K deficiency, as expressed by high dp-ucMGP levels, showed independently associations with mortality and CVEs in CAPD patients.

Keywords

Vitamin K status Desphospho-uncarboxylated matrix GLA protein Mortality Peritoneal dialysis 

Notes

Acknowledgements

We express our deepest gratitude to all patients who participated in the study and all nephrologists and nurses in our PD center for their helpful assistance.

Funding

This research was funded by Medical Scientific Research Foundation of Guangdong Province, China (Grant No. 2015122194432203-A201563).

Compliance with ethical standards

Conflict of interest

The authors have no financial conflicts of interest to declare.

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of NephrologyJiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen UniversityGuangdongPeople’s Republic of China
  2. 2.Department of NephrologyCentral Municipal Hospital of HuizhouGuangdongPeople’s Republic of China
  3. 3.Clinical Trials Unit, The First Affiliated HospitalSun Yat-sen UniversityGuangdongPeople’s Republic of China
  4. 4.Department of Nephrologythe 2nd Affiliated Hospital of Guangzhou Medical UniversityGuangdongPeople’s Republic of China

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