Vitamin K2 supplementation and arterial stiffness among renal transplant recipients-a single-arm, single-center clinical trial

Subclinical vitamin K deficiency is prevalent among renal transplant recipients and is associated with an increased risk of cardiovascular disease. However, the association between vitamin K supplementation and improvement of arterial stiffness has not been explored in the renal transplant populatio...

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Bibliographic Details
Published in:	Journal of the American Society of Hypertension Vol. 11; no. 9; p. 589
Main Authors:	Mansour, Anthony G, Hariri, Essa, Daaboul, Yazan, Korjian, Serge, El Alam, Andrew, Protogerou, Athanase D, Kilany, Hala, Karam, Albert, Stephan, Antoine, Bahous, Sola Aoun
Format:	Journal Article
Language:	English
Published:	United States 01-09-2017
Subjects:	Adult Biomarkers - blood Calcium-Binding Proteins - blood Dietary Supplements Extracellular Matrix Proteins - blood Female Humans Kidney Failure, Chronic - blood Kidney Failure, Chronic - therapy Kidney Transplantation Male Matrix Gla Protein Middle Aged Pilot Projects Prevalence Prospective Studies Pulse Wave Analysis Renal Dialysis Treatment Outcome Vascular Calcification - blood Vascular Calcification - drug therapy Vascular Calcification - epidemiology Vascular Stiffness - drug effects Vitamin K - blood Vitamin K 2 - therapeutic use Vitamin K Deficiency - blood Vitamin K Deficiency - drug therapy Vitamin K Deficiency - epidemiology Vitamins - therapeutic use pulse wave velocity Menaquinone
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Summary:	Subclinical vitamin K deficiency is prevalent among renal transplant recipients and is associated with an increased risk of cardiovascular disease. However, the association between vitamin K supplementation and improvement of arterial stiffness has not been explored in the renal transplant population. The KING trial (vitamin K2 In reNal Graft) is a single-arm study that evaluated the association between the change in vitamin K status and indices of arterial stiffness following 8 weeks of menaquinone-7 (vitamin K2) supplementation (360 μg once daily) among renal transplant recipients (n = 60). Arterial stiffness was measured using carotid-femoral pulse wave velocity (cfPWV). Subclinical vitamin K deficiency was defined as plasma concentration of dephosphorylated-uncarboxylated matrix Gla protein (dp-ucMGP) >500 pmol/L.At baseline, 53.3% of the study subjects had subclinical vitamin K deficiency. Supplementation was associated with a 14.2% reduction in mean cfPWV at 8 weeks (cfPWV pre-vitamin K2 = 9.8 ± 2.2 m/s vs. cfPWV post-vitamin K2 = 8.4 ± 1.5 m/s; P < .001). Mean dp-ucMGP concentrations were also significantly reduced by 55.1% following menaquinone-7 supplementation with a reduction in the prevalence of subclinical deficiency by 40% (P = .001). When controlled for age, durations of hemodialysis and transplantation, and the change in 24-hour mean arterial pressure, the improvement in arterial stiffness was independently associated with the reduction in dp-ucMGP concentration (P = .014).Among renal transplant recipients with stable graft function, vitamin K2 supplementation was associated with improvement in subclinical vitamin K deficiency and arterial stiffness. (Clinicaltrials.gov: NCT02517580).
ISSN:	1878-7436
DOI:	10.1016/j.jash.2017.07.001