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Erschienen in: Endocrine 2/2016

01.02.2016 | Original Article

Calcimimetic and vitamin D analog use in hemodialyzed patients is associated with increased levels of vitamin K dependent proteins

verfasst von: Maria Fusaro, Sandro Giannini, Maurizio Gallieni, Marianna Noale, Giovanni Tripepi, Maurizio Rossini, Piergiorgio Messa, Paolo Rigotti, Tecla Pati, Francesco Barbisoni, Antonio Piccoli, Andrea Aghi, Marianna Alessi, Luciana Bonfante, Fabrizio Fabris, Sabina Zambon, Stefania Sella, Giorgio Iervasi, Mario Plebani

Erschienen in: Endocrine | Ausgabe 2/2016

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Abstract

Matrix Gla protein (MGP) and bone Gla protein (BGP) are two vitamin K-dependent proteins (VKDPs) involved in the regulation of vascular calcification (VC). We carried out a secondary analysis of the VIKI study to evaluate associations between drug consumption and VKDP levels in 387 hemodialyzed patients. The VIKI study assessed the prevalence of vitamin K deficiency in hemodialysis patients. We evaluated drug consumption, determined BGP and MGP levels, and verified the presence of any vertebral fractures (VF) and VC by spine radiographs. Total BGP levels were twice as high with calcimimetics versus no calcimimetics (290 vs. 158.5 mcg/L, p < 0.0001) and 69 % higher with vitamin D analogs (268 vs. 159 mcg/L, p < 0.0001). Total MGP was 19 % higher with calcimimetics (21.5 vs. 18.1 mcg/L, p = 0.04) and 54 % higher with calcium acetate (27.9 vs. 18.1 mcg/L, p = 0.003); no difference was found with vitamin D analogs (21.1 vs. 18.3 mcg/L, p = 0.43). Median Total BGP level was 29 % lower in patients with ≥1 VF (151 vs. 213 mcg/L, p = 0.0091) and 36 % lower in patients with VC (164 vs. 262.1 mcg/L, p = 0.0003). In non-survivors, median BGP and MGP were lower, but only for MGP this difference reached the statistical significance (152 vs. 191 mcg/L, p = 0.20 and 15.0 vs. 19.7 mcg/L, p = 0.02, respectively). Pending studies on vitamin K supplementation, calcimimetics, and vitamin D analogs may play a role in preserving vitamin K-dependent protein activity, thus contributing to bone and vascular health in CKD patients.
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Metadaten
Titel
Calcimimetic and vitamin D analog use in hemodialyzed patients is associated with increased levels of vitamin K dependent proteins
verfasst von
Maria Fusaro
Sandro Giannini
Maurizio Gallieni
Marianna Noale
Giovanni Tripepi
Maurizio Rossini
Piergiorgio Messa
Paolo Rigotti
Tecla Pati
Francesco Barbisoni
Antonio Piccoli
Andrea Aghi
Marianna Alessi
Luciana Bonfante
Fabrizio Fabris
Sabina Zambon
Stefania Sella
Giorgio Iervasi
Mario Plebani
Publikationsdatum
01.02.2016
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 2/2016
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-015-0673-z

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