Intervention Of Vitamin K2 On Vascular Calcification In Maintenance Hemodialysis Patients

Objectives:To study the effect of vitamin k2 supplementation on coronary artery calcification and arterial stiffness in maintenance hemodialysis patients.Method:The maintenance hemodialysis patients were divided into two groups,The experimental group received 270 ?g vitamin k2 daily and the control group did not,All of them were observed for 12 months.The primary endpoint was coronary artery calcification(CAC)score,and the secondary endpoint was carotid-femoral pulse wave velocity(cfPWV)measured before and 12 months after intervention.CAC score(Agatston score)was measured using multi-slice spiral Computer Tomography every 12 months,cfPWV was measured using Colour Doppler Ultrasound every 6 months,basic biochemical parameters and iPTH were measured every 6 months.Results:1.A total of 80 patients with maintenance hemodialysis were included in this study,75 of whom completed the whole study.The vitamin K2 group and control group showed no significant difference in age,sex,duration of dialysis,coexisting disease,calcium,phosphorus and iPTH level at baseline and at the end of this study.2.The baseline,6 months and 12 months cfPWV of the trial group were 11.05 ±2.83 m/s,10.54 ±3.00 m/s and 10.06 ±3.04 m/s respectively(P<0.05),and the difference was statistically significant.The baseline decreased by 0.51 ±0.55 m/s at 6 months and 0.99 ±0.95 m/s by 12 months.In the control group,the baseline,6 months and 12 months cfPWV levels were 10.88 ±2.77 m/s,11.41 ±2.87 m/s,11.99 ±3.00 m/s respectively(P<0.05),the difference was statistically significant.The baseline increased by 0.53 ±0.26 m/s in 6 months and 1.11 ±0.54 m/s in 12 months.The baseline and 12 months CAC scores in the trial group were 147.59±130.86 and 140.00±151.62 respectively(P>0.05),and the difference was not statistically significant.In the control group,the baseline and 12 months CAC scores were 152.10 ±106.06 and 210.18 ±132.17 respectively(P<0.05),and the CAC scores at 12 months were 58.08 ±33.14 higher than the baseline level.3.According to the stratification of iPTH level,the experimental group was divided into two groups: in the group of the iPTH ? 600 pg/mL,the baseline and 12 months CAC score were 267.94±167.15 and 300.29±167.09 respectively(P<0.05),the difference was statistically significant,the CAC score at 12 months was higher than the baseline.Inthe group of iPTH < 600pg/mL group,the baseline and 12 months CAC score were 114.76 ±98.85 and 96.29 ±115.23 respectively(P<0.05).The difference was statistically significant.The CAC score of 12 months was lower than the baseline level.Conclusions:1.Vitamin K2 supplementation may improve arterial stiffness in maintenance hemodialysis patients.2.Vitamin K2 supplementation may postpone the progression of CAC in maintenance hemodialysis patients.3.Vitamin K2 supplementation may reduce the vascular calcification in maintenance hemodialysis patients with iPTH lower than 600 pg/mL.