Calcimimetic and vitamin D analog use in hemodialyzed patients is associated with increased levels of vitamin K dependent proteins

被引：23

作者：

Fusaro, Maria ^{[1
]}

Giannini, Sandro ^{[2
]}

Gallieni, Maurizio ^{[3
]}

Noale, Marianna ^{[1
]}

Tripepi, Giovanni ^{[4
]}

Rossini, Maurizio ^{[5
]}

Messa, Piergiorgio ^{[6
]}

Rigotti, Paolo ^{[7
]}

Pati, Tecla ^{[8
]}

Barbisoni, Francesco ^{[9
]}

Piccoli, Antonio ^{[10
]}

Aghi, Andrea ^{[10
]}

Alessi, Marianna ^{[10
]}

Bonfante, Luciana ^{[10
]}

Fabris, Fabrizio ^{[2
]}

Zambon, Sabina ^{[2
]}

Sella, Stefania ^{[2
]}

Iervasi, Giorgio ^{[11
]}

Plebani, Mario ^{[12
]}

机构：

[1] CNR, Neurosci Inst, Natl Res Council, Via Giustiniani 2, I-35128 Padua, Italy

[2] Univ Padua, Dept Med, Clin Med 1, Padua, Italy

[3] Univ Milan, Dept Biomed & Clin Sci L Sacco, San Carlo Borromeo Hosp, Nephrol & Dialysis Unit, Milan, Italy

[4] CNR, IFC Pathophysiol Renal Dis & Hypertens Unit, Reggio Di Calabria, Italy

[5] Univ Verona, Dept Med, Rheumatol Unit, I-37100 Verona, Italy

[6] IRCCS, Fdn Ca Granda, Osped Maggiore Policlin, Milan, Italy

[7] Univ Padua, Dept Surg Oncol & Gastroenterol Sci, Kidney Pancreas Transplant Unit, Padua, Italy

[8] Hosp Rovigo, Nephrol & Dialysis Unit, Rovigo, Italy

[9] Hosp Lodi, Nephrol & Dialysis Unit, Lodi, Italy

[10] Univ Padua, Nephrol Unit, Padua, Italy

[11] CNR, Inst Clin Physiol, Via Savi 8, I-56100 Pisa, Italy

[12] Univ Padua, Dept Med, Lab Med Unit, Padua, Italy

来源：

ENDOCRINE | 2016年 / 51卷 / 02期

关键词：

Matrix mineralization; Biochemical markers of bone turnover; CKD; Vitamin K proteins; Vascular calcification; CHRONIC KIDNEY-DISEASE; MATRIX GLA-PROTEIN; STAGE RENAL-DISEASE; VASCULAR CALCIFICATIONS; VERTEBRAL FRACTURES; MINERAL METABOLISM; BONE; OSTEOCALCIN; DIALYSIS; PROGRESSION;

D O I：

10.1007/s12020-015-0673-z

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Matrix Gla protein (MGP) and bone Gla protein (BGP) are two vitamin K-dependent proteins (VKDPs) involved in the regulation of vascular calcification (VC). We carried out a secondary analysis of the VIKI study to evaluate associations between drug consumption and VKDP levels in 387 hemodialyzed patients. The VIKI study assessed the prevalence of vitamin K deficiency in hemodialysis patients. We evaluated drug consumption, determined BGP and MGP levels, and verified the presence of any vertebral fractures (VF) and VC by spine radiographs. Total BGP levels were twice as high with calcimimetics versus no calcimimetics (290 vs. 158.5 mcg/L, p < 0.0001) and 69 % higher with vitamin D analogs (268 vs. 159 mcg/L, p < 0.0001). Total MGP was 19 % higher with calcimimetics (21.5 vs. 18.1 mcg/L, p = 0.04) and 54 % higher with calcium acetate (27.9 vs. 18.1 mcg/L, p = 0.003); no difference was found with vitamin D analogs (21.1 vs. 18.3 mcg/L, p = 0.43). Median Total BGP level was 29 % lower in patients with a parts per thousand yen1 VF (151 vs. 213 mcg/L, p = 0.0091) and 36 % lower in patients with VC (164 vs. 262.1 mcg/L, p = 0.0003). In non-survivors, median BGP and MGP were lower, but only for MGP this difference reached the statistical significance (152 vs. 191 mcg/L, p = 0.20 and 15.0 vs. 19.7 mcg/L, p = 0.02, respectively). Pending studies on vitamin K supplementation, calcimimetics, and vitamin D analogs may play a role in preserving vitamin K-dependent protein activity, thus contributing to bone and vascular health in CKD patients.

引用

页码：333 / 341

页数：9

共 26 条

[1] Changes in bone mineral metabolism parameters, including FGF23, after discontinuing cinacalcet at kidney transplantation [J].