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Effect of vitamin K1 supplementation on coronary calcifications in hemodialysis patients: a randomized controlled
Hilda Elizabeth Macias-Cervantes1, Marco Antonio Ocampo-Apolonio2, Rodolfo Guardado-Mendoza3
1Internal Medicine Department, Unidad Medica de Alta Especialidad, Hospital de Especialidades No. 1, Centro Médico Nacional del Bajío, León, Guanajuato, México. hildamacer@gmail.com.
Insights
Vitamin K1 supplementation significantly slowed coronary artery calcification progression in Mexican hemodialysis patients. This finding suggests a potential therapeutic role for vitamin K1 in managing cardiovascular risks associated with chronic kidney disease.
Area of Science:
- Nephrology
- Cardiology
- Nutritional Science
Background:
- Chronic kidney disease (CKD) is linked to adverse cardiovascular outcomes, including coronary heart disease.
- Arterial calcification severity predicts coronary heart disease risk and premature cardiovascular death.
- Experimental models suggest vitamin K1 may reduce coronary artery calcifications.
Purpose of the Study:
- To evaluate the effect of intravenous vitamin K1 supplementation on coronary artery calcification progression in hemodialysis patients.
- To assess the efficacy of vitamin K1 in reducing arterial calcification in a high-risk population.
Main Methods:
- A single-center clinical trial randomized 60 Mexican hemodialysis patients with coronary calcification scores >10 Agatston units.
- Participants received 10 mg intravenous vitamin K1 or placebo thrice weekly for 12 months.
- Primary outcome: absolute change in Agatston and coronary calcium volume scores.
Main Results:
- After 12 months, the vitamin K1 group showed a coronary calcium score of 78.50 Agatston units versus 344 in the placebo group (p=0.05).
- Progression of coronary calcification was 20.8% in the vitamin K1 group compared to 44% in the placebo group.
- Vitamin K1 supplementation demonstrated a relative risk of 0.45 for progression.
Conclusions:
- Intravenous vitamin K1 supplementation reduced coronary artery calcification progression by 55% in Mexican hemodialysis patients over 12 months.
- Vitamin K1 may be a promising intervention for mitigating cardiovascular complications in CKD patients.
Background:
Chronic kidney disease (CKD) is associated with several adverse cardiovascular outcomes, including coronary heart disease, heart failure, and arrhythmias. The severity of arterial calcifications predicts the risk of coronary heart disease and increases the risk of premature cardiovascular death. In experimental models, vitamin K1 supplementation appears to reduce coronary artery calcifications.
Methods:
In this single-center clinical trial (NCT04247087 on 07/09/2019), we randomized 60 Mexican patients on chronic hemodialysis and a coronary calcification score > 10 Agatston units to receive 10 mg intravenous vitamin K1 or placebo at the end of the hemodialysis session thrice weekly for 12 months. The primary outcome was the progression of coronary artery calcifications as assessed by the absolute change in Agatston and coronary calcium volume scores.
Results:
The baseline coronary calcium score was 112.50 (14-2027) Agatston units in the vitamin K1 group and 177 (10-2843); Agatston units in the placebo group (p = 0.71), and after 12 months, the coronary calcium score in the vitamin K1 group was 78.50 (10-1915) Agatston units in the vitamin K1 group versus 344 (10-3323); Agatston units (p = 0.05) in the placebo group. Progression of coronary calcification was 20.8% in the vitamin K1 group versus 44% in the placebo group, with a relative risk (RR) of 0.45 (CI 95% 0.18-1.15).
Conclusions:
In the Mexican hemodialysis cohort enrolled in this study intravenous vitamin K1 supplementation reduced the progression of coronary artery calcifications by 55% compared with placebo over a 12-month follow-up period.
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