Assessment of potential biomarkers of subclinical vitamin K deficiency in patients with end-stage kidney disease

Canadian Journal of Kidney Health and Disease
Meghan J ElliottRachel M Holden

Abstract

A significant proportion of hemodialysis patients have functional, but modifiable, vitamin K deficiency. To determine the correlates of poor vitamin K status in hemodialysis patients. Cross-sectional study. Hemodialysis units at Kingston General Hospital and its satellite centres, Ontario, Canada. Patients undergoing outpatient hemodialysis for end-stage kidney disease. Serum concentrations of phylloquinone, undercarboxylated prothrombin, also known as protein induced by vitamin K absence or antagonism - factor II (PIVKA-II), and the percentage of undercarboxylated osteocalcin (%ucOC). Vitamin K status was determined in fasting blood samples of hemodialysis patients. Bivariate relationships were examined using parametric and non-parametric statistics as appropriate. Multivariable linear regression models were applied to identify predictors of vitamin K status. Among 44 HD patients, criteria for subclinical vitamin K deficiency were met in 13.6% (phylloquinone < 0.4 nmol/L), 51% (%ucOC > 20%) and 90.9% (PIVKA-II > 2.0 nmol/L) of subjects. Phylloquinone levels were positively associated with total cholesterol, triglyceride levels and non-smoking status. Higher %ucOC was associated with increased calcium-phosphate product. Increas...Continue Reading

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