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Clin Nutr. 2015 Apr;34(2):235-40. doi: 10.1016/j.clnu.2014.03.011. Epub 2014 Apr 2.

Vitamin K intake and mortality in people with chronic kidney disease from NHANES III.

Author information

1
Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China; Centre for Genomic Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China; Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong, China; Research Centre of Heart, Brain, Hormone and Healthy Aging, The University of Hong Kong, Pokfulam, Hong Kong, China. Electronic address: lung1212@hku.hk.
2
Institute for Aging Research, Hebrew SeniorLife, 1200 Centre St., Boston, MA 02131, USA; Harvard Medical School, Boston, MA, USA.
3
Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China; Centre for Genomic Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China; Research Centre of Heart, Brain, Hormone and Healthy Aging, The University of Hong Kong, Pokfulam, Hong Kong, China.
4
Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong, China.
5
Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong, China; Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China. Electronic address: wongick@hku.hk.

Abstract

BACKGROUND & AIMS:

Cardiovascular disease (CVD) is the leading cause of death in patients with chronic kidney disease (CKD), partly due to increased vascular calcification. Vitamin K plays a role in preventing vascular calcification in CKD yet the relationship between vitamin K intake and mortality in CKD patients remains unclear.

METHODS:

This observational cohort study included 3401 participants with CKD from the Third National Health and Nutrition Examination Survey. Vitamin K intake was estimated from 24-h dietary recalls (1988-94). Mortality was determined from the National Death Index records through 2006. Cox-proportional hazards regression was used to estimate Hazard Ratios (HR) by comparing those with adequate intake of vitamin K to those with low intake, adjusting for advanced CKD covariates. For sensitivity analysis, these associations were also examined among those with different renal status.

RESULTS:

During a median follow-up of 13.3 years (37,408 person-years), 1815 and 876 participants died from all-cause and CVD causes, respectively. 72% of the participants had vitamin K intake lower than the recommended adequate intake. Participants with vitamin K intake higher than recommended adequate intake for vitamin K were associated with lower risk of all-cause (HR = 0.85; 95%: 0.72-1; P = 0.047) and CVD mortality (HR = 0.78; 95%: 0.64-95; P = 0.016). Sensitivity analyses in subgroups with advanced CKD revealed similar findings.

CONCLUSIONS:

This observational study suggests that adequate intake of vitamin K may be associated with reduced all-cause and CVD mortality in CKD patients. However, vitamin K may be a marker of a healthy diet; therefore clinical trials may help in clarifying the effect of vitamin K independent of a healthy diet.

KEYWORDS:

Cardiovascular disease; Chronic kidney disease; Mortality; Vitamin K; Warfarin

PMID:
24745600
DOI:
10.1016/j.clnu.2014.03.011
[Indexed for MEDLINE]
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