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J Am Soc Hypertens. 2017 Sep;11(9):589-597. doi: 10.1016/j.jash.2017.07.001. Epub 2017 Jul 13.

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

Author information

1
Lebanese American University School of Medicine, Byblos, Lebanon.
2
Department of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, USA.
3
Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA.
4
Cardiovascular Prevention and Research Unit, Department of Pathophysiology, "Laiko" Hospital, Medical School, National & Kapodistrian University of Athens, Athens, Greece.
5
Lebanese American University School of Medicine, Byblos, Lebanon; Division of Nephrology and Transplantation, Department of Medicine, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon.
6
Lebanese American University School of Medicine, Byblos, Lebanon; Division of Nephrology and Transplantation, Department of Medicine, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon. Electronic address: sola.bahous@lau.edu.lb.

Abstract

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).

KEYWORDS:

Menaquinone; pulse wave velocity

PMID:
28756183
DOI:
10.1016/j.jash.2017.07.001
[Indexed for MEDLINE]

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