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Sevelamer Use, Vitamin K Levels, Vascular Calcifications, and Vertebral Fractures in Hemodialysis Patients: Results from the VIKI Study
Journal of bone and mineral research, 2021-03, Vol.36 (3), p.500-509
Fusaro, Maria
Cozzolino, Mario
Plebani, Mario
Iervasi, Giorgio
Ketteler, Markus
Gallieni, Maurizio
Aghi, Andrea
Locatelli, Francesco
Cunningham, John
Salam, Syazrah
Zaninotto, Martina
Ravera, Maura
Russo, Domenico
Mereu, Maria Cristina
Giannini, Sandro
Brandi, Maria Luisa
Ferrari, Serge
Sella, Stefania
Egan, Colin Gerard
Bellasi, Antonio
Di Lullo, Luca
Tripepi, Giovanni
Nickolas, Thomas
2021
Details
Autor(en) / Beteiligte
Fusaro, Maria
Cozzolino, Mario
Plebani, Mario
Iervasi, Giorgio
Ketteler, Markus
Gallieni, Maurizio
Aghi, Andrea
Locatelli, Francesco
Cunningham, John
Salam, Syazrah
Zaninotto, Martina
Ravera, Maura
Russo, Domenico
Mereu, Maria Cristina
Giannini, Sandro
Brandi, Maria Luisa
Ferrari, Serge
Sella, Stefania
Egan, Colin Gerard
Bellasi, Antonio
Di Lullo, Luca
Tripepi, Giovanni
Nickolas, Thomas
Titel
Sevelamer Use, Vitamin K Levels, Vascular Calcifications, and Vertebral Fractures in Hemodialysis Patients: Results from the VIKI Study
Ist Teil von
Journal of bone and mineral research, 2021-03, Vol.36 (3), p.500-509
Ort / Verlag
Hoboken, USA: John Wiley & Sons, Inc
Erscheinungsjahr
2021
Link zum Volltext
Quelle
Wiley Online Library Journals
Beschreibungen/Notizen
ABSTRACT Hyperphosphatemia is a risk factor for vascular calcifications (VCs), which are part of the chronic kidney disease‐mineral and bone disorders (CKD‐MBD). Vitamin K‐dependent proteins such as matrix Gla protein (MGP) and bone Gla proteins (BGP, or osteocalcin) can inhibit VCs and regulate bone mineralization. In this analysis of the Vitamin K Italian (VIKI) study, the relationship between vitamin K status, vertebral fractures (VFs) and VCs in 387 hemodialysis (HD) patients with (N = 163; 42.1%) or without N = 224; 57.9%) sevelamer was evaluated. Levels of vitamin K vitamers K1 and K2 or menaquinones (MK; MK4–7), total and undercarboxylated (uc) forms for both BGP and MGP were determined. Although no differences in clinical characteristics were noted, lower levels of MK4 (0.45 versus 0.6 ng/mL, p = .01) and a greater MK4 deficiency was observed in sevelamer‐treated patients (13.5% versus 5.4%, p = .005). Multivariate logistic regression revealed that MK4 deficiency was associated with sevelamer use (odds ratio [OR] = 2.64, 95% confidence interval [CI] 1.25–5.58, p = .011) and aortic calcification (OR = 8.04, 95% CI 1.07–60.26, p = .04). In the same logistic model, sevelamer amplified the effect of total BGP levels on the odds of VFs in patients with total BGP <150 μg/L compared with those with total BGP ≥150 μg/L (OR = 3.15, 95% CI 1.46–6.76, p = .003). In contrast, there was no such effect in those untreated (total BGP <150 μg/L versus total BGP ≥150 μg/L: OR = 1.21, 95% CI 0.66–2.23, p = .54]; p = .049 for effect modification by sevelamer). Sevelamer may interfere with MK4 levels in HD patients and interact with low BGP levels to increase bone fractures in CKD patients. © 2020 American Society for Bone and Mineral Research (ASBMR).
Sprache
Englisch
Identifikatoren
ISSN: 0884-0431
eISSN: 1523-4681
DOI: 10.1002/jbmr.4214
Titel-ID: cdi_proquest_miscellaneous_2460760373
Format
–
Schlagworte
Aorta
,
Bone diseases
,
Calcification (ectopic)
,
Fractures
,
HEMODIALYSIS
,
Hyperphosphatemia
,
Kidney diseases
,
Menaquinones
,
Mineralization
,
Osteocalcin
,
Risk factors
,
SEVELAMER
,
VASCULAR CALCIFICATION
,
Vertebrae
,
VERTEBRAL FRACTURES
,
VITAMIN K
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